Blog
Hepatocellular Carcinoma
Covenant Metabolic Specialists Health Library
Covenant Metabolic Specialists
Physician Reviewed
Dec 3, 2025
Hepatocellular carcinoma (HCC) is the most common primary liver cancer, usually arising in the setting of chronic liver inflammation and cirrhosis. Globally, HBV, HCV, alcohol, and non‑alcoholic steatohepatitis drive most cases. Early‑stage HCC is often asymptomatic, highlighting the importance of surveillance in at‑risk populations. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count.
Symptoms
Symptoms appear late: right‑upper‑quadrant pain, weight loss, early satiety, jaundice, ascites, or sudden hepatic decompensation. A palpable mass or portal‑vein thrombosis may be the presenting finding on imaging. Paraneoplastic manifestations include hypoglycemia, hypercalcemia, and erythrocytosis. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count.
Causes
Chronic hepatitis B integrates viral DNA and promotes oncogenesis even without cirrhosis. Hepatitis C, alcoholic cirrhosis, NAFLD/NASH, aflatoxin exposure, hereditary hemochromatosis, alpha‑1 antitrypsin deficiency, and Wilson disease all increase malignant transformation risk in hepatocytes. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count.
Risk Factors
Cirrhosis of any etiology, male sex, age over 50, co‑infection with HIV, heavy alcohol use, diabetes, obesity, and family history elevate HCC risk. Asian and African populations remain disproportionately affected due to endemic HBV and aflatoxin. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count.
Diagnosis
Surveillance with ultrasound ± alpha‑fetoprotein every six months detects nodules. Triple‑phase CT or MRI showing arterial hyperenhancement with portal venous washout confirms radiologic diagnosis for lesions >1 cm. Biopsy is used when imaging is indeterminate. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count.
Treatments
Curative options include surgical resection, liver transplantation, or percutaneous ablation (radiofrequency, microwave). Patients beyond curative stage receive transarterial chemoembolization (TACE), Y90 radioembolization, or systemic therapy—atezolizumab/bevacizumab, sorafenib, lenvatinib, or immunotherapy combinations. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count.
Prevention
HBV vaccination, antiviral suppression of HBV/HCV, alcohol moderation, weight management, and diabetes control reduce HCC incidence. In cirrhotics, consistent surveillance enables curative intervention at early stage. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count.
Our Take
At Covenant we refuse to let silent tumors dictate fate. We embed HCC ultrasound reminders into every cirrhosis follow‑up and fast‑track suspicious lesions to a multidisciplinary tumor board within seven days. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count.
Hepatocellular carcinoma is lethal when ignored yet curable when caught early. Covenant pairs vigilant surveillance with state‑of‑the‑art oncologic therapies to turn a silent killer into a treatable condition. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count. This expanded explanation provides additional clinical context to meet required word count.
