Hepatocellular Carcinoma Flashcards
What are the commonest tumour type in the liver.
The commonest (90%) liver tumours are secondary tumours.
What are the common secondary tumour sites of liver metastases. (3)
Breast.
Bronchus.
GIT.
What are the symptoms of liver cancer. (8)
Fever.
Malaise.
Anorexia.
Weight loss.
RUQ pain (due to liver capsule stretch).
Jaundice is late (except with cholangiocarcinoma).
Benign tumours are often asymptomatic.
Tumours may rupture causing intraperitoneal haemorrhage.
What are the physical signs of liver cancer. (5)
Hepatosplenomegaly (smooth, or hard and irregular eg metastases, cirrhosis, HCC).
Signs of chronic liver disease (eg ‘liver flap’, spider naevie, duptryn’s contracture, caput medusae, etc…).
Evidence of decompensated liver failure (jaundice, ascites).
Feel for abdominal mass.
Listen for a bruit over the liver (HCC).
What percentage of primary liver cancers are due to HCC.
90%.
Where is HCC common. (2)
China.
Africa.
What percentage of cancers does HCC account for in China and Africa.
40%.
What percentage of cancers does HCC account for in the UK.
2%.
What is the ratio of men:women who develop HCC.
3:1.
What are the typical clinical features of a patient with HCC. (8)
Fatigue. Fever. Decreased appetite. RUQ pain. Jaundice. Ascites. Haemobilia.
What are the causes of HCC. (8)
HBV is the leading cause. HCV. AIH. Cirrhosis (alcohol, haemochromatosis, PBC). Non-alcoholic fatty liver. Aflatoxin. Clonorchis sinensis. Anabolic steroids.
How common is HCC.
HCC is the 5th most common cancer worldwide.
How does HCC metastasise. (2)
Via the hepatic or portal veins.
Where does HCC metastasise to. (3)
Lymph nodes.
Bone.
Lungs.
What may be raised in the blood test of a patient with HCC.
Alpha-fetoprotein may be raised, but is normal in at least a third of patients.
