Benign and Malignant Liver Neoplasms Flashcards
1
Q
What are the benign liver neoplasms?
A
- Haemangioma
- Focal nodular hyperplasia
- Adenoma
2
Q
What is a haemangioma?
A
Most common benign hepatic tumours resulting from malformation of angioblastic foetal tissue
3
Q
What is the most primary malignant liver neoplasm?
A
Hepatocellular carcinoma
4
Q
RFx for HCC?
A
- Chronic liver inflammation (Hep B/C), cirrhosis (esp macronodular), haemochromatosis, a1 antitrypsin deficiencyy
- Rx: OCP, steroids
- Smoking, alcohol, betel nuts
- Chemical carcinogens: aflatoxins, microcystin, vinyl chloride
5
Q
Clinical features of HCC?
A
- RUQ discomfort
- R shoulder pain
- Jaundice
- Fatigue, LoW
- Fever (if central tumour necrosis)
- Hepatomegaly, bruit
- Ascites with blood
- Paraneoplastic syndromes
- Mets
6
Q
Ix in HCC?
A
- LFTs: elevated ALP, bilirubin
- a-fetoprotein inc
- U/S
- Triphasic CT (enhancement on arterial phase and washout on portal venous phase)
- MRI
- Biopsy
7
Q
Rx HCC?
A
- Surgical resection (10%)
- Transplant
- Non surgical: radio frequency ablation, percutaneous ethanol injection, transcatheter arterial embolisation (TACE), chemotherapy, RT
8
Q
Prognosis HCC?
A
Median survival 6-20m
5% 5yr survival
9
Q
What is the most common hepatic malignancy?
A
Secondary (i.e. mets)
10
Q
Aetiology of hepatic mets?
A
Some GU cancers produce bumpy lumps Stomach GenitoUrinary (kidney, ovary, uterus) Colon Pancreas Breast Lung
11
Q
Rx secondary hepatic mets?
A
hepatic resection if control of primary is possible and no other mets.
