tumours of the Liver

Question 1

what are the two primary liver tumours

Answer 1

Hepatocellular adenoma 
Hepatocellular carcinoma (hepatoma)

Question 2

can be hepatocellular or _____ (bile ducts)

Answer 2

cholangiocarcinomas

Question 3

the vast majority are ___ tumours

Answer 3

secondary

Question 4

hepatocellular adenomas are more common in ____

Answer 4

females

Question 5

most adenomas are ____ but can ___ and ___

Answer 5

asymptomatic, rupture and bleed

Question 6

what is hepatocellular carcinoma associated with?

Answer 6

HBV, HCV and Cirrhosis

Haemochromatosis and PBC

Question 7

what is cholangiocarcinoma associated with?

Answer 7

PSC

Question 8

what is the clinical presentation of heptocellular carcinoma?

Answer 8

Usually presents as a mass, pain, obstruction
Usually advanced unless discovered incidentally

can also have worsening of pre-existing chronic liver disease

Question 9

-__ prognosis for carcinoma

Answer 9

poor

Question 10

what are the risk factors for HCC?

Answer 10

HBV
HCV
Alcohol
Aflatoxin

Others: things that cause cirrhosis - NASH, autoimmune hepatitis, PBC

Question 11

what may be found on examination of HCC?

Answer 11

Signs of cirrhosis
Hard enlarged RUQ mass
Liver bruit (rare)

Question 12

what is measured in the lab to test for HCC?

Answer 12

AFP - alfa fetoprotein

very small tumours may not secrete it

Question 13

how is HCC diagnosed?

Answer 13

Elevated AFP
US
Triphasic CT scan: very early arterial perfusion
MRI

Question 14

resection of HCC is Feasible for small tumours with preserved ____ function
(no jaundice or portal HTN)

Answer 14

liver

Question 15

___ ___ is given for people with HCC that is non resectable or with advanced cirrhosis

recurrence rate is high

Answer 15

local ablation

Question 16

what are the options of treatment for HCC?

Answer 16

resection, local ablation and chemoembolisation

Question 17

chemoembolisation is Only in patients with early ____ and well preserved ____ function

Answer 17

Only in patients with early cirrhosis and well preserved liver function

Question 18

this is the carcinoma which presents in young patients and is not related to cirrhosis

Answer 18

fibrolamellar carcinoma

Question 19

AFP is normal in this carcinoma

Answer 19

fibrolamellar

Question 20

what is the managemtn of fibrolamellar?

Answer 20

surgical resection or transplantation

TACE for patients with an unresectable tumours

Question 21

this malignancy - Mild _____ picture (___) with preserved liver function

Answer 21

secondary metastasis