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Gastrointestinal > Hepatobilliary Neoplasia > Flashcards

Hepatobilliary Neoplasia Flashcards

1
Q

The most common neoplasms of the liver are:

A

Metastatic tumors

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2
Q

The most common tumor sites that metastasize to the liver are?

A

Colon, Stomach, Pancrea, Breast, Lung

Cancer sometimes penetrates benign liver

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3
Q

Hepatocellular carcinoma prognosis?

A

Its bad, less than 5%

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4
Q

Hepatocellular carcinoma is what>

A

Malignant epithelial neoplasm of the liver composed of cells resembling hepatocytes to a greater or lesser degree

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5
Q

Epidemiology of hepatocellular carcinoma?

A

3x more common in males, 3x more common in asian americans

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6
Q

Hepatocellular carcinoma is most common in pts with what?

A

Viral hepatitis

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7
Q

Pts with hepatocellular carcinoma present with what?

A

Jaundice, encephalopathy, ascites, bleeding, mild-moderate abdominal pain, wt. loss, diarrhea, bone pain

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8
Q

What are the useful predictors of prognosis for hepatocellular carcinoma?

A

Size
Differentiation
Invasion and Metastasis
Presence or Absence of Cirrhosis

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9
Q

Why is biopsy a risky procedure in HCC?

A

Because many Hepatocellular carcinomas are highly vascularized. You can get a massive hemorrhage if you’re not careful

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10
Q

Most common HCC histologic patterns?

A

Microtrabecular and macrotrabecular

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11
Q

Major serum protein marker for hepatocellular carcinoma

A

alpha-fetoprotein

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12
Q

Whats the problem with alpha fetoprotein being the major marker?

A

It is also elevated in acute or chronic liver injury, gonadal tumors, pregnancy, and some gastric cancers

Over 20 the specificity is 91%
Over 200 the specificity is 99%

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13
Q

What is the mainstay treatment for liver cancer?

A

Surgical resection

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14
Q

Surgical resection is problematic however because most pts are not eligible due to tumor extent or underlying liver dysfunction

A

ok

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15
Q

What are some other treatments for liver cancer?

A

Inject ethanol into the tumor…pretty awesome

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16
Q

Hepatic adenomas are most common in what kinds of pts

A

Those who have taken or are taking anabolic steroids, androgenic steroids, or estrogenic steroids

BIRTH CONTROL

17
Q

Are hepatic adenomas malignant?

A

nope…they go away when you stop taking the drug

18
Q

Note that hepatic adenomas may expand during pregnancy because of the increase in estrogen levels…tehy are estrogen sensitive. This increases the possibility of rupture and intraperitoneal hemorrhage.

A

The tumors will regress as soon as the pregnancy is over though

19
Q

Most common benign tumor in the liver

A

Hemangioma

20
Q

Hemangioma histo>

A

blood filled vascular space

21
Q

Hepatoblastoma

A

Rare malignant epithelial neoplasm in children

22
Q

Cholangiocarcinoma

A

Malignant epithelial neoplasm with Biliary differentiation

23
Q

Cholangiocarcinoma epidemiology

A

more common in males

Ages 50-70

24
Q

Cholangiocarcinoma strongly associated with what other condition

A

Primary sclerosing cholangitis

25
Q

Extrahepatic cholangiocarcinoma at the bifurcation of the hepatic bile duct is called?

A

Klatskin tumor

26
Q

KRAS mutation in what percent of intrahepatic tumors?

Extrahepatic

A

50%

15% extrahepatic

27
Q

appearance of cholangiocarcinoma?

A

tan-white (no bile made)

28
Q

cholangiocarcinoma spreads mostly via what route?

A

Lymph

29
Q

Cholangiocarcinoma histo

A

abnormal tubular structures embedded in a dense fibrous matrix

30
Q

Extrahepatic cholangiocarcinoma symptoms

A

Pruritis, RUQ pain, wt loss, Jaundice, clay colored stool and dark urine,

Lab: high bilirubin
highalk phos

31
Q

Entrahepatic cholangiocarcinoma symptoms

A

dull RUQ pain and wt loss

Lab: bilirubin may be normal or a little high
alk phos will be high

32
Q

Cholangiocarcinoma prognosis

A

Bad

33
Q

Gall Bladder carcinoma more common in who

A

Its really rare overall but most common in females, hispanics, native americans

34
Q

Risk factors of gall bladder cancer?

A

gall stones

35
Q

Liver mets have what appearance

A

multiple, rounded, potentially hemorrhagic or necrotic

36
Q

Liver mets often allow surprisingly normal function of the liver due to regeneration capacity

A

ok

Gastrointestinal (58 decks)

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