Cholangiocarcinoma + 2^ tumours

Question 1

What is cholangiocarcinoma?
What % of all liver cancer?

Answer 1

Arises from biliary tree, typically adenocarcinomas
10%

Question 2

CC
RF?

Answer 2

parasitic lukewarm, biliary cysts, IBD, PSC

Question 3

Patient Sx?

Answer 3

Abdo pain, jaundice, weight loss, fevers, pruritus (itchy skin)
Non specific = Courvoisier sign (but pancreatic cancer. much more common usually)

Question 4

why are Sx usually late?

Answer 4

tumour is slow growing

Question 5

Dx of CC?
What would be raised?
First line and GS?

Answer 5

may show High CEA + CA19-9
LFT = High bilirubin and ALP

1st = Abdo USS + CT

GS = ERCP (imaging of biliary tree)
Invasive but can stent structures present in tree and obtain sample for biopsy

Biosy

Question 6

Tx for CC?

Answer 6

Majority of cases inoperable as Px presents very late

Question 7

What are 2 Benign liver 1^ tumours?

Answer 7

Haemangioma
hepatic adenoma

Question 8

Benign liver 1^ tumours
Haemangioma:
MC ?
seen as?

Answer 8

MC - seen in infants as ‘strawberry mark’ on skin within first few weeks of life

Question 9

2^ tumours
are they more or less common than 1^ liver tumours?
From where?

Answer 9

More common
GIT, Lung (bronchial), breast

Question 10

Dx of 2^ tumours?

Answer 10

High serum ALP
1st = USS
GS = CT/MRI chest and abdo for staging and 1^ tumour

Question 11

Tx of 2^ tumours?

Answer 11

surgical resection if possible , of 1^ cancer, hepatic
chemo