Liver cancer

Question 1

What is the commonest liver tumour?

Answer 1

Metastasis from other cancers

Question 2

What are the 2 main primary liver tumours, and of these 2 which is the most common?

Answer 2

Hepatocellular carcinoma (most common) and cholangiocarcinoma

Question 3

Name 3 common origins of secondary liver tumours

Answer 3

• Stomach
• Lung
• Colon
• Breast

Question 4

Name 2 symptoms of liver cancer

Answer 4

• Fever
• Malaise
• Weight loss and anorexia
• RUQ pain

Question 5

Name 2 signs of liver cancer

Answer 5

• Hepatomegaly
• Abdominal mass
• Signs of liver disease
• Signs of decompensated liver disease i.e. jaundice, ascites
• Bruit over the liver

Question 6

1) What is a tumour marker for hepatocellular carcinoma?
2) What is a tumour marker for cholangiocarcinoma?
3) Name 2 other investigations that may be used in the diagnosis of liver cancer

Answer 6

1) Alpha-fetoprotein
2) CA19-9
3) Liver ultrasound, MRI, CT, ERCP/biopsy

Question 7

Hepatocellular carcinoma (HHC)
1) What is the leading worldwide cause of HHC?
2) Name 2 other causes/risk factors
3) Name a kinase inhibitors that are licensed as medical treatment for HCC
4) What are the 2 curative treatments for HHC?

Answer 7

1) Hepatitis B
2) Alcohol, non alcoholic fatty liver disease, hepatitis C, haemochromatosis, PBC
3) Sorafenib, regorafenib and lenvatinib
4) Complete surgical resection and liver transplant

Question 8

Cholangiocarcinoma
1) How does it often present?
2) Name a cause
3) How can cholangiocarcinoma potentially be cured?

Answer 8

1) Painless jaundice
2) PSC, hepatitis B and C, Caroli’s disease, biliary cysts
3) Surgical resection

Question 9

What are the commonest benign liver tumours?

Answer 9

Hepatic haemangiomas