Hepatic Lesions Flashcards
1
Q
What are features of hepatocellular carcinoma (HCC)?
A
- 3rd most common cause of cancer worldwide
- Chronic hep B is most common cause of HCC worldwide
- Chronic hep C most common cause in Europe
2
Q
The biggest risk factor for developing HCC is liver cirrhosis, for example, secondary to Hep B and C, alcohol, haemochromatosis and primary biliary cirrhosis.
What are other risk factors for HCC?
A
- a-1 antitrypsin deficiency
- Hereditary tyrosinosis
- Glycogen storage disease
- Aflatoxin
- Drugs → COCP, anabolic steroids
- Porphyria cutanea tarda
- Male sex
- Diabetes mellitus, metabolic syndrome
3
Q
What is the clinical presentation of HCC?
A
- Presents late
- Features of liver cirrhosis or failure may be seen → jaundice / ascites / RUQ pain / hepatomegaly / pruritus / splenomegaly
- Possible presentation is decompensation in a patient w/ chronic liver disease
- Raised AFP
4
Q
What is the screening for HCC?
A
- Ultrasound
- +/- alpha-fetoprotein
5
Q
Who is screening reserved for?
A
High risk groups
- Pts w/ liver cirrhosis secondary to hep B and C or haemochromatosis
- Men w/ liver cirrhosis secondary to alcohol
6
Q
What are management options for HCC?
A
- Early disease → surgical resection
- Liver transplantation
- Radiofrequency ablation
- Transaterial chemoembolism
- Sorafenib (multikinase inhibitor)
