Flashcards in Malignant Liver lesions Deck (27):
1
What are the 5 main malignant liver tumours
Hepatocellular carcinoma (HCC)
Fibro-lamellar carcinoma of the liver
Hepatoblastoma
Intrahepatic cholangiocarcinoma
Metastases
2
What is the most common primary liver cancer
Hepatocellular carcinoma
3
Who is likely to have HCC
Saudi Men
4
What is the most important risk factor for HCC
Cirrhosis
5
What 4 things can cause HCC
Hep B
Hep C
Alcohol
Aflatoxin
6
What is aflatoxin
Mould on peanuts
7
Is HCC usually symptomatic or asymptomatic?
Asymptomatic
8
What are the 2 common presentations for HCC in those who are symptomatic
Weight loss and RUQ pain
9
Where are the 6 common places for HCC metastases
Rest of the lvier,
Via the portal vein
Lymph nodes
Lung
Bone
Brain
10
What is the most common protein marker for HCC
Alfa feto protein (AFP)
11
What is the problem with testing AFP?
An elevation is only seen in 70% of the patients
12
How can we diagnose HCC
Elevated AFP
US
Triphasic CT
MRI
Biopsy
13
What is the prognosis of HCC
Depends on the tumour size and whether there is extrahepatic spread
Underlying liver disease
14
What is the best available treatment for HCC
Liver transplantation
15
When are we able to do a liver transplantation for patients with HCC
If there is only a single tuour which is less than 5cm or if there are less than 3 tumours less than 3cm each
16
When is HCC resection feasible
For small tumours with preserved liver function (no jaundice or portal Hypertension
17
What can we do for a patient with non resectable HCC
Local Ablation
18
What type of technique is local ablation
Palliative
19
What does radio frequency ablation involve
Putting devices into the liver and cooking boiling or killing them with alcohol
20
How is chemoembolisation performed
Inject chemotherapy into the hepatic artery
21
Who is most likely to get fibro-lamellar carcinoma
Young patients - 5-35
22
What is fibro-lamellar carcinoma not related to
Cirrhosis
23
What does a CT show in fibro-lamellar Carcinoma
Stellate scar with radial septa showing persistant enhancement
24
Where is the most common site for blood born metastases
Liver
25
Where are the common primaries metastases
Colon
Breast
Lung
Stomach
Pancreas
Melanoma
26
How can we diagnose secondary liver metastases
Imaging or FNA
27