Malignant transformation of cirrhotic liver

Liver cirrhosis (LC) is a disease of the liver characterised by replacement of the normal liver architecture by nodules. It is a disease that is commonly diagnosed at a late stage in Nigeria. Chronic hepatitis B infection is the most common cause of LC in Nigeria, probably followed by chronic hepatitis C virus (HCV) infection and alcohol consumption. LC often transforms to hepatocellular carcinoma (HCC) and this may be diagnosed for the first time at presentation. In fact, most HCC in Nigeria occur on a background of LC in up to 80% of cases. Few cases of LC that are therefore diagnosed at an early stage will need good clinical and laboratory assessment and skilled management to mitigate early transformation to HCC. The pathogenesis and pathogenetic pathways LC transforms to HCC as well as the roles chronic hepatitis B virus and HCV play in the transformation are highlighted. In addition, the detection of early onset of HCC in the cirrhotic liver and the challenges of investigation modalities and treatment are the highlights of this review article.