Hepatocellular Carcinoma Flashcards
Define Hepatocellular Carcinoma?
Primary Malignancy of the liver parenchyma
What is Hepatocellular Carcinoma associated with?
Chronic Liver Damage
Metabolic Disease
Aflatoxins
What are some examples of chronic liver damage?
Alcoholic Liver damage
Hepatitis C
Autoimmune C
What is an example of Metabolic Disease?
Haemochromatosis
What is an example of Aflatoxins?
Cereals contaminated with fungi
What is the epidemiology of hepatocellular carcinoma?
Common
1-2% of all malignancies
Less common than liver metastases
High incidence in regions where hepatitis B and C are endemic
What are the presenting symptoms of hepatocellular carcinoma?
Symptoms of malignancy
History of exposure to carcinogens
Abdominal Distension
Jaundice
What are some symptoms of malignancy?
Malaise
Weight Loss
Loss of appetite
What is included in the history of exposure to carcinogens?
High alcohol intake
Hepatitis B or C (e.g. sexual activity, IV drug use)
Aflatoxins
What are the signs of Hepatocellular Carcinoma on physical examination?
Signs of Malignancy Hepatomegaly (may be nodular) Jaundice Ascites Bruit over the liver
What signs of malignancy do you usually see in Hepatocellular Carcinoma?
Cachexia
Lymphadenopathy
What bloods would you do for Hepatocellular Carcinoma?
FBC ESR LFTs Clotting a-fetoprotein Hepatitis serology
What is a-feroprotein?
Tumour marker for liver cancer
What imaging would you do for Hepatocellular Carcinoma?
Abdominal US
CT/MRI - gold standard for staging
What Histology/Cytology might you do for Hepatocellular Carcinoma?
Ascitic Tap maybe sent for cytological analysis
