Liver Cancers

Question 1

Aetiologies?

Answer 1

Metastases from lung/breast/GIT

Risk factors for primary carcinoma - hepatitis, cirrhosis, being male, age

Question 2

Pathology?

Answer 2

Without cirrhosis = single mass lesion
With cirrhosis = single or multiple lesions
Can release alpha-fetoprotein into bloodstream

Question 3

Signs and Symptoms?

Answer 3

Fever, malaise, anorexia, weight loss, RUQ pain, late jaundice
Hepatomegaly, RUQ mass, Abdominal artery bruit, Hepatic bruit, Bleeding

Question 4

Investigations and findings?

Answer 4

Alpha-fetoprotein - may be present but not diagnostic
USS - lesions visualised
CT scan
Tests for primary cancer

Question 5

Management?

Answer 5

Prevention best overall intervention
Chemotherapy + surgery can only increase life expectancy
Hepatic resection, percutaneous ablation
Transplant only curative measure

Question 6

Complications?

Answer 6

Prognosis is bleak