Hepatocellular Carcinoma

Question 1

What is the commonest cause of liver cancer?

Answer 1

This

Question 2

When does it commonly occur?

Answer 2

In the background of cirrhosis: commonly occurs in association with chronic hepatitis B + C

Question 3

How are cirrhotic patients monitored?

Answer 3

Every 6 months, patients with cirrhosis have these investigations carried out

Question 4

How does it present?

Answer 4

Decompensation of liver disease
Abdominal mass
Abdominal pain
Weight loss
Bleeding from tumour

Question 5

What investigations are carried out?

Answer 5

Tumour markers: AFP
Radiological tests: US, CT, MRI
Liver biopsy done very rarely

Question 6

What are the treatment options?

Answer 6

Hepatic resection
Liver transplant
Chemotherapy: locally delivered or systemic chemotherapy
Locally ablative treatments: alcohol injection, radio frequency ablation
Sorafenib (tyrosinase kinase inhibitor)
Hormonal therapy: Tamoxifen

Question 7

What are the different liver tumours?

Answer 7

Hepatocellular carcinoma = malignant tumour of hepatocytes
Cholangiocarcinoma = malignant tumour of bile duct epithelium
Metastatic tumours = common site of metastasis