Hepatocellular Carcinoma

Question 1

What is a common feature of most liver cancers?

2 common causes?

Most common risk worldwide

Answer 1

Secondary - from mets

NAFLD
ALD

Viral hepatitis - HBV vaccine reduces this

Question 2

Presentation - 2

Answer 2

Chronic liver disease or acute decompensation, the latter being a bad prognostic sign

Question 3

Investigations:

What should be done if liver USS shows nodules <1cm?

What should be done if liver USS shows nodules >1cm?

Answer 3

Repeat USS in 6 months

CT or MRI + biopsy

Question 4

Management:

First-line for patients with solitary tumours that are < 5cm?

What is done if unresectable?

What can be done for localised but unresectable disease?

Answer 4

Surgical resection

Transplantation

Radiofrequency ablation