Liver Cancer Flashcards

1
Q

what is common and what are rare

A

primary adenomas and carcinomas rare; more often to get metastasis from somewhere else

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2
Q

what are benign lesions

A
hemangioma
focal nodular hyperplasia 
hepatic adenoma
hydatid cysts 
polycystic liver disease
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3
Q

what is hemangioma

A

common in non-cirrhotic pateints
well demarcated spot on US; usually asymptomatic
no treatment

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4
Q

what is focal nodular hyperplasia

A

central scar containing large artery, radiating branches to large periphery

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5
Q

what presents histiologically with FNH

A

sinusoids, dile ductules and kupffer cells

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6
Q

who does FNH affect

A

young and middle-aged women; usually asymptomatic

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7
Q

what does FNH look like on US and CT

A

nodule with varying echogenicity on US and hypervascular mass with central scar on CT
no treatment

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8
Q

what is hepatic adenoma associated with

A

women

glycogen storage disease and oral contraceptive pill

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9
Q

what is symptom of hepatic adenoma

A

often asymptomatic, may have RUQ pain

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10
Q

how to diagnose hepatic adenoma

A

US (filling defect), CT (diffuse arterial enhancement)

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11
Q

how to treat hepatic adenoma

A

stop hormones, weight loss
males - always surgery
female - surgery if >5cm

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12
Q

complication of hepatic adenoma

A

can rupture or bleed

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13
Q

what causes hydatid cysts

A

echinococcus granulosus
eastern europe, central america, south america, middle east and north africa
farmers - sheep parasites?

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14
Q

what may patients with hydatid cysts present with

A

disseminated disease or erosion of cyst into adjacent structure and vessels (IVC)

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15
Q

what treatment used in hydatid cysts

A

surgery - open cystectomy or pericystectomy
medical - albendazole
percutaneous drainage

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16
Q

how does polycystic liver disease arise

A

due to embryonic malformation of bile ducts

17
Q

how does polycystic liver disease present

A

abdominal pain and distension

18
Q

what is treatment of polycystic liver disease

A

conserve treatment to halt cyst growth

invasive (defenestration or transplant) rarely used - only with co-morbidities

19
Q

what are malignant tumours of liver

A

hepatocellular carcinoma and fibro-lamellar carcinoma

20
Q

is hepatocellular carcinoma most common liver cancer

A

yes

21
Q

what is risk factor for hepatocellular carcinoma

A

cirrhosis from any cause (also HBV and HCV)

22
Q

what are signs of hepatocellular carcinoma

A

weight loss, RUQ pain, mass, worsening of pre-existing liver disease, acute liver failure

23
Q

examination findings of hepatocellular carcinoma

A

signs of cirrhosis, hard enlarged RUQ mass, liver bruit (rare)

24
Q

what is treatment of hepatocellular carcinoma

A

transplant
resection (small tumours)
local ablation (non resectable tumours with advanced cirrhosis)
TACE (inject chemo selectively in hepatic artery - only if early cirrhosis)

25
Q

when does fibro-lamellar carcinoma present

A
young patients (5-35)
not related to cirrhosis - AFP normal
26
Q

what does CT show in fibro-lamellar carcinoma

A

stellate scar with radial septa showing persistent enhancement

27
Q

what is treatment in fibro-lamellar carcinoma

A

surgical resection or transplant

TACE for non resectable tumour

28
Q

what is general causes of liver cancer

A

cirrhosis
alcohol, smoking or drugs
hepatitis
autoimmune disease

29
Q

what is general symptoms

A

weight loss
hepatomegaly
abdominal pain
lymphadenopathy

30
Q

what is stages of diagnosis

A

US -> CT -> liver biopsy

31
Q

what causes liver abscess

this isny cancer just didnt know where to put it

A

coliforms
anaerobes
enterococci
staph aureus

32
Q

how to treat liver abscess

A

IV gentamicin +
IV amoxicillin +
IV metrondiazole