Malignant Liver lesions Flashcards Preview

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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

What does treatment depend on for secondary liver metastases

The primary cancer

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