[Primary liver cancer in the tropical environment. Classical and current data]

Area of Science:

• Hepatology
• Oncology
• Tropical Medicine

Background:

• Primary liver carcinoma, predominantly hepatoma, is highly prevalent in tropical regions, particularly in Black Africa.
• The etiology of this hepatoma subtype remains largely unexplained, with distinct clinical and etiological features compared to European or North African counterparts.

Purpose of the Study:

• To investigate the unique characteristics of hepatoma in tropical Africa.
• To identify potential etiological factors and diagnostic markers for this specific liver cancer.
• To explore treatment modalities and prophylactic strategies.

Main Methods:

• Clinical observation and comparison of hepatoma cases in tropical Africa with those in other regions.
• Biochemical analysis for humoral syndrome markers (hypoglycemia, hypercholesterolemia, hyperlipemia, alkaline phosphatases).
• Radioimmunoassay for alpha fetoprotein detection; etiological investigation focusing on Hepatitis B virus and aflatoxin.

Main Results:

• Hepatoma in this population occurs in younger patients (around 35 years), exhibits rapid progression, and is associated with post-hepatitic rather than alcoholic cirrhosis.
• A characteristic humoral syndrome includes hypoglycemia, hypercholesterolemia, hyperlipemia, and elevated alkaline phosphatases.
• Alpha fetoprotein is detected in 85% of cases; Hepatitis B virus and aflatoxin are implicated as co-factors.

Conclusions:

• Hepatoma in tropical Africa presents unique clinical and etiological profiles, strongly linked to Hepatitis B virus and aflatoxin.
• Early diagnosis may be aided by specific humoral markers and alpha fetoprotein levels.
• Surgical resection (partial hepatectomy) is the preferred treatment, with chemotherapy as an alternative; viral hepatitis immunization offers future prophylactic hope.