Liver cancer

Question 1

with liver cancer there are primary & secondary tumors that occur there, tends to be more _____ in the liver though

Answer 1

secondary

Question 2

secondary (metastized) tumors are more common in the liver why?

Answer 2

-liver is richly vascularized, more emoboli coming through

Question 3

what are the two types of primary tumors that develop in the liver

Answer 3

• hepatocellular carcinoma

- cholangiocarcinomas

Question 4

more than 80% of the primary tumors in the liver are

Answer 4

-hepatocellular carinoma

Question 5

where does hepatocellular carcinoma originate?

Answer 5

in the hepatocytes

Question 6

what is the etiology of hepatocellular carcinoma (what is it lined to?

Answer 6

• chronic liver disease (eg. hepatits) (b/c virus gets into host cell & incorporates their genetic materail into the hosts of the DNA so damage the DNA in hepatocytes causing mutation in gene)
• enviromental toxins (eg. arsenic) induces mutation and lose regulation excessive CA cells develop

Question 7

hepatocellular carcinoma

Answer 7

• more than 80% of primary liver cancer this type

- originates in the hepatocytes

Question 8

manifestations of hepatocellular carcinoma

Answer 8

• insidous onset
• masked by underlying liver disease (pt may have hep C or Chronic liver disease, msked by mnfts of liver disease therefore cancer not usually detected early)

Question 9

the manifestations of hepatocellular carcinoma has what type of onset

Answer 9

insidious

Question 10

what is the treatment of hepatocellular carcinoma

Answer 10

• poor prognosis (advanced at diagnosis)
• partial hepatectomy (if can, challenge to find small tumor in liver)
• palliative chemo & radiation (only do chemo & radiation if have substantial benefits & lengthen life do not want to add distress to end of life)

Question 11

where do you see hepatic adenoma

Answer 11

see in young women 20-30 on oral contraceptives which the cancer growth is supported by hormones

Question 12

cholangiocarcinomas

Answer 12

• other type of primary liver cancer
• less common
• originates in bile duct epithelium (cholestic)

Question 13

metastic secondary tumors

Answer 13

usually from colon, lung & breast

Question 14

mnfts of secondary tumors

Answer 14

• those of liver disease (hepatomegaly, ascites, abdm pain)

- anorexia, fever, wt loss

Question 15

treatment of secondary tumors

Answer 15

• very poor prognosis (because primary tumor is still there)

- supportive & palliative