Hepatobiliary Malignancies Flashcards
What is the most common source of liver cancer?
Metastasis from other organs.
Which lobes does the falciform ligament run between?
Between2/3 and 4.
What are the main functions of the liver?
Glycogen storage
Bile production
Coagulation factors
Blood filter
What are the different Benign Liver Lesions
FNH-Focal Nodular Hyperplasia
Simple Cyst
Hemangioma
Adenoma
What is the defining feature of Focal Nodular Hyperplasia?
Nodular hyperplastic parenchyma with one or more macroscopic central scars.
What are the traits of Liver Cell Adenoma?
Rare proliferation of Benign hepatocytes
symptomatic 1/2 the time
Risk of rupture or malignant proliferation
What are the traits of Hemangiomas?
Most common benign tumor of the liver;
microscopically, Endothelium lined, blood filled spaces;
>5cm are termed giant hemangiomas
What is the type of liver cancer that develops from hepatocytes?
Hepatocellular Carcinoma
What is cancer that develops within the intrahepatic bile ducts?
Cholangiocarcinoma
What are the risk factors for HCC?
Males Aflatoxin Hep B/C Cirrhosis Hemochromatosis Wilson's disease alpha 1 Anti Trypsin deficiency NASH, Non-alcoholic Steatohepatitis
What is the main cause of NASH?
Obesity
What is the leading cause of cirrhosis?
Alcohol abuse
What is the leading cause of Primary Billiary cirrhosis?
Autoimmune disease
What are Aflatoxins?
Cancer causing substance that is produced from fungi. more common in warmer and tropical climates.
What are the main types of HCC?
Hepatocellular: Solitary, diffuse, and fibrolamellar
Cholangiocarcinoma, and Hepabtoblastoma
What is the tumor marker for HCC?
Alpha feto-protein(AFP)
Can monitor recurrence of tumors.
What are surgical treatments for Liver Cancer?
Wedge Resection
Lobectomy
Trisegmentectomy
Liver Transplant-Rare
What are the challenges of liver surgery?
Dual blood supply
Hepatic Reserve
Coagulopathy-removing the ability for the liver to produce clotting factors. Can be very bloody surgeries!
What does the Pugh Score tell you?
Risk of adverse events in surgery.
What defines an optimal tumor resection candidate?
Solitary tumors without major vascular invasion
Which vessels are closed in Liver embolization treatment?
Hepatic arteries.
What is the role of Sorafenib in Liver cancer therapy?
It is a targeted therapy that blocks tumors from forming new blood vessels. Targets surface proteins
Where is the most common location of CholangioCA?
Perihilar Region (Branch ing point between ducts)
What is the clinical presentation of CholangioCA?
Signs of Biliary Tract obstruction.
Painless Jaundice. Pruritis
What is the Role of ERCP in CholangioCA?
Collect biopsies in Bile Duct, Stent, direct imaging.
What procedure is used if there is distal location of cholangioCA?
Whipple Procedure
What are palliative options for Cholangio CA?
Biliary Decompression/ relief of obstruction
Radiation
Chemotherapy
In what demographic is Gallbladder cancer most common?
Leading cause of death in Chilean Women.
Rare in North America.
More common in Women
What is a pocelain Gallbladder?
Calcification of the wall of the Gall Bladder
What group of people does the best with Gallbladder cancer treatment?
T1a= cancer limited to mucosa and lamina propria.
