Hepatocellular carcinoma

Question 1

most common cause of HCC?

Answer 1

from cirrhosis due to :

Chronic hepatitis B is the most common cause world wide

chronic hepatitis C being the most common cause in Europe

alcohol,

haemochromatosis (WILSON DISEASE DECEPTION DOES NOT CAUSE HCC!!!)

and primary biliary cirrhosis

Question 2

Other risk factors include?

Answer 2

alpha-1 antitrypsin deficiency

hereditary tyrosinosis

glycogen storage disease

aflatoxin

drugs: oral contraceptive pill, anabolic steroids
porphyria cutanea tarda

male sex

diabetes mellitus, metabolic syndrome

Question 3

clinical features of HCC ?

Answer 3

liver cirrhosis or failure may be seen: jaundice, ascites, RUQ pain, hepatomegaly, pruritus, splenomegaly

Question 4

who should be screened for hcc?

Answer 4

liver cirrhosis secondary to hepatitis B & C or haemochromatosis

men with liver cirrhosis secondary to alcohol

Question 5

how to screen patients for HCC?

Answer 5

with ultrasound
(+/- alpha-fetoprotein)

Question 6

x

Question 7

x

Question 8

x

Question 9

x

Question 10

x

Question 11

x

Question 12

management of HCC in early disease ?

Answer 12

surgical resection

Question 13

management of HCC in late stage ?

Answer 13

liver transplantation

radiofrequency ablation

transarterial chemoembolisation

sorafenib: a multikinase inhibitor