liver cancer

Question 1

what are the 2 different types of cancer and how prevalent is each?

Answer 1

hepatocellular carcinoma (80%) and cholangiocarcinoma (20%).

Question 2

what are the main risk factors for hepatocellular carcinoma?

Answer 2

Viral hepatitis (B and C)
Alcohol
Non alcoholic fatty liver disease
Other chronic liver disease

Question 3

what are the main risk factors for cholangiocarcinoma?

Answer 3

primary sclerosing cholangitis. However, only 10% of patients with cholangiocarcinoma had primary sclerosing cholangitis.

Question 4

what are symptoms of liver cancer?

Answer 4

Weight loss
Abdominal pain
Anorexia
Nausea and vomiting
Jaundice
Pruritus

Question 5

what is the tumour marker for hepatocellular carcinoma?

Answer 5

Alpha-fetoprotein is a tumour marker for hepatocellular carcinoma.

Question 6

what is the tumour marker for cholangiocarcinoma?

Answer 6

CA19-9 is a tumour

Question 7

what is a Haemangioma?

Answer 7

common benign tumours of the liver. They are often found incidentally. They cause no symptoms and have no potential to become cancerous. No treatment or monitoring is required.

Question 8

what is the treatment for hepatoocellular carcinoma?

Answer 8

• poor prognosis unless detected early and resectable disease
• kinase inhibitors can extend life expectancy by a few months such as…

sorafenib, regorafenib and lenvatinib.

• hepatocellular carcinoma is resistant to chemo and radiotherapy

Question 9

what is the treatment of cholangiocarcinoma?

Answer 9

• early diagnosis-> resection can cure in rare cases
• ERCP to put a bile duct drain if it is compressing the bile duct-> this can lead to improved symptoms
• resistant to chemo and radiotherapy

Question 10

what is a focal nodular hyperplasia and what is it associated with?

Answer 10

Focal nodular hyperplasia is a benign liver tumour made of fibrotic tissue. This is often found incidentally. It is usually asymptomatic and has no malignant potential. It is often related to oestrogen and is therefore more common in women and those on the oral contraceptive pill. No treatment of monitoring is required.