Flashcards in Liver Cancer Deck (83)
What % of liver cancers are metastatic?
What % of liver cancers are primary?
What is the main primary liver tumour?
How common is hepatocellular carcinoma compared to other cancers?
6th most common cancer worldwide
How deadly is hepatocellular carcinoma compared to other cancers?
It is the third leading cause of cancer death
How do the incidence rates of hepatocellular cancer differ throughout the world?
They vary significantly across the globe, with China having a high incidence and UK having a low incidence
Who do the majority of cases of hepatocellular carcinoma in the UK occur in?
Those aged over 70 years
What % of hepatocellular carcinoma in the UK occurs in males?
What does hepatocellular carcinoma arise as a result of?
Chronic inflammatory processes affecting the liver
What is the most common cause of chronic inflammation leading to HCC worldwide?
What are the other common causes of inflammation leading to HCC?
Primary biliary cirrhosis
What is aflatoxin?
A toxic fungal metabolite that can be found on cereals and nuts
What are the risk factors for hepatocellular carcinoma?
High alcohol intake
Family history of liver disease
What are the most common causative organisms of viral hepatitis leading to HCC?
Hepatitis B virus
Hepatitis C virus
What % of HCC cases are accounted for by viral hepatitis in developing countries?
Which demographic is HCC more commonly found in developing countries?
Why is HCC more common in Asian individuals?
Secondary to childhood infections with hepatitis B
Why is the incidence of HCC caused by Hep B decreasing?
Due to current vaccination programmes
What % of cases of HCC in the UK are thought to arise secondary to hepatitis?
What is the relationship between the combined oral contraceptive pill and HCC?
While the combined oral contraceptive pill is known to increase the risk of hepatic adenomas, data remains inconclusive regarding its relationship with malignant disease
What are the main symptoms of hepatocellular carcinoma?
That of liver cirrhosis, and may include vague, non-specific symptoms such as fatigue, fever, weight loss, and lethargy
Does hepatocellular carcinoma cause a dull ache in the right upper abdomen?
It is uncommon, however when present is characteristic of hepatocellular carcinoma, and should raise suspicion in patients with known cirrhosis
How might advanced HCC present?
Features of liver failure, such as worsening ascites or jaundice
What will be found on examination in HCC?
An irregular, enlarged, craggy and tender liver
What may the differential diagnoses include in a patient presenting with liver failure or non-specific liver signs?
Benign hepatocellular adenoma
Other causes of liver cirrhosis
What will suggest a diagnosis of infectious hepatitis rather than HCC?
Presence of non-specific serology
What will suggest a diagnosis of cardiac failure rather than HCC?
What investigations should be done in HCC?
What may the bloods show in HCC?
Deranged liver function tests (ALP, AST, ALT, bilirubin)
Low platelets or prolonged clotting