Hepatocellular Carcinoma Flashcards
Where is liver cancer is the the incidence rates?
1 - 6th most common
2 - most common
3 - 2nd most common
4 - 10th most common
1 - 6th most common
- 4th most common causing mortality
The incidence in the UK is 5.1 vs 17.7 /100,000 in eastern Asia. What is the most common cause for this?
1 - alcohol
2 - liver cirrhosis
3 - autoimmune
4 - chronic viral hepatitis
4 - chronic viral hepatitis
- rates of HBV and HCV are more common in Asia
What is the most common cause of hepatocellular carcinoma in the western world?
1 - alcohol excess
2 - chronic viral hepatitis
3 - autoimmune
4 - medications
1 - alcohol excess
Is hepatocellular carcinoma more common in men or women?
- equal
What age does the incidence of hepatocarcinoma peak in the developed world?
1 - 20-40
2 - 30-50
3 - 40-60
4 - >70
3 - 40-60
- in developing countries it is 20-40 y/o
Which of the following has an increased incidence that has been linked to hepatocellular carcinoma?
1 - DM and NAFLD
2 - age
3 - autoimmune
4 - medications
1 - DM and NAFLD
Does hepatocellular carcinoma present early with obvious symptoms?
- no
- normally an incidental finding on CT / MRI / US
Hepatocellular carcinoma does not present early with obvious symptoms. In late disease which of the following are we unlikely to see as a clinical presentation?
1 - jaundice
2 - weight loss
3 - abdominal pain and distension
4 - small bowel obstruction
4 - small bowel obstruction
- Jaundice can present early due to biliary tree obstruction and late due to liver failure
Although it may not be the best, what method is generally the first line to identify a mass?
1 - PET/CT
2 - ultrasound
3 - MRI
4 - CT
2 - ultrasound
Ultrasound is generally used to identify a mass on the liver, but what imaging modality is more sensitive and can also be used for staging?
1 - PET/CT
2 - X-ray
3 - MRI
4 - CT
4 - CT
Although ultrasound and CT can identify and lesion and stage a liver mass, what is generally required to confirm a diagnosis of hepatocellular carcinoma?
1 - ALT
2 - liver biopsy
3 - alpha fetoprotein (AFP)
4 - GGT / LDH / bilirubin
2 - liver biopsy
- alpha fetoprotein (AFP), GGT / LDH and bilirubin are also used clinically
What is the most commonly used tumour marker for identifying the presence of hepatocellular carcinoma?
1 - Carbohydrate antigen 19-9 (CA19-9)
2 - Breast cancer type 1 (BRCA1)
3 - Carcinoembryonic antigen (CEA)
4 - Alpha-fetoprotein (AFP)
4 - Alpha-fetoprotein (AFP)
> 200 is suspicious
400 is confirmative
In patients with known cirrhosis, they should be monitored every 6 months for the risk of hepatocarcinoma using what?
1 - Alpha-fetoprotein (AFP)
2 - ultrasound
3 - CT
4 - liver biopsy
2 - ultrasound
When we discuss surgery for patients with hepatocellular carcinoma, which of the 2 following approaches are commonly used?
1 - resection of the tumour
2 - tumour laser ablation
3 - liver transplantation
4 - tumour embolism
1 - resection of the tumour
3 - liver transplantation
- must be very careful with liver cirrhosis
Which of the following are NOT common non surgical approaches to a patient with hepatocellular carcinoma?
1 - tumour ablation (percutaneous ethanol injection or radio-frequency ablation)
2 - chemoembolism (TACE)
3 - radiotherapy
4 - immunotherapy
5 - palliative support
4 - immunotherapy
