Hepatocellular carcinoma, an underdiagnosed entity: An autopsy series

Hepatocellular carcinoma is the most frequent primary malignant tumor of the liver. In Mexico, it is one of the main causes of death. It tends to be detected at late stages of the disease, making its prognosis poor in most cases. It has a wide range of clinical presentation and histologic subtypes, which can also have prognostic implications. We conducted an autopsy study series, in which we identified a total of 34 cases of hepatocellular carcinoma over a 6-year period, accounting for 1.37% of all the postmortem studies. The disease was slightly more frequent in men, with a 1.42:1 ratio, and in the sixth decade of life. The conventional subtype was more frequent, and the main cause of death was hypovolemic shock due to gastrointestinal bleeding. A striking datum was that only 38.2% of the cases were diagnosed before the autopsy report, underlining the need to improve protocols for the early detection of hepatocellular carcinoma.