الفهرس 
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Abstract
Summary
Pimary malignant liver neoplasm is considered as one of the most frequent
cancer world wide. There are many aetiologic factors as regard hepatocellular
carcinoma ”HCC”, the most frequent and strong aetiol.ogic factors claimed in .
”HCC” are liver cirhosis and hepatitis B & C .
Different laboratory modalities of the liver has a role in diagnosis, but the
most important tumour marker is serum alpha feto protein together with serum
ferritin, it is the most sensitive and diagnostic. The combination of both of
them make the diagnosis more accurate.
Regarding the imaging modalities, the DIS enhanced with intra-arterial
injection of C02 microbubbles was found to detect small ”HCC” lcm in
diameter, so it is the most sensitive.
The management of ”HCC” includes surgical management and non surgical
one.
Surgical treatment carries the main hope for cure in ”HCC” it includes liver
resection and liver transplantation. Liver resection is the main line of treatment
in lesions extended unilaterally either into the right or left liver but leaves the
contralateral half of the liver free of tumour. Liver transplantation for ”HCC”
is indicated in those large tumours involving more than one lobe and those near
the porta hepatis and also in cirrhotic liver.
Combination of different modalities of treatment of ”HCC” improves the
results and survival rate.
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Recurrence rate after surgery for ”BCC” was found to be 50% after liver
resection and 40% after liver transplantation. So, the best result obtained in
small asymptomatic tumours.
The non-surgical management is used in large tumours extending outside the
liver and if there is a distant metastases and in patient with bad general
condition i.e., cannot withstand surgery. Those options are: hepatic artery
ligation, embolization of liver tumours, chemotherapy, ethanol injection,
cryotherapy