Liver Cancer

Question 1

What is a primary liver cancer?

Answer 1

Liver that originates in the liver

Question 2

What is a secondary liver cancer?

Answer 2

Mets in the liver

Question 3

What are the two main types of primary liver cancer?

Answer 3

• Hepatocellular carcinoma (80%)

- Cholangiocarcinoma (20%)

Question 4

Where may liver mets come from?

Answer 4

Pretty much any cancer- often an unknown primary

Question 5

What is the prognosis like with liver mets?

Answer 5

Poor

Question 6

What are the risk factors of hepatocellular carcinoma?

Answer 6

Liver cirrhosis, often due to:
BANC

Hep B
AFLD
NAFLD
Hep C

Question 7

How is HCC screening carried out?

Answer 7

6 monthly:

• Alpha-fetoprotein
• USS

Question 8

What is cholangiocarcinoma associated with?

Answer 8

Primary sclerosing cholangitis (10% of chol.Ca)

Question 9

How do liver cancers present?

Answer 9

Late:

• Weight loss, anorexia..
• Abdo pain
• N and V
• Jaundice
• Pruritis

Question 10

Which two cancers cause a painless jaundice?

Answer 10

• Pancreatic cancer

- Cholangiocarcinoma

Question 11

What is the tumour marker for hepatocellular carcinoma?

Answer 11

Alpha-fetoprotein

Question 12

What is the tumour marker for cholangiocarcinoma?

Answer 12

CA19-9

Question 13

What are CTs and MRIs used for in liver cancer?

Answer 13

Staging

Question 14

What is ERCP used for in liver cancer?

Answer 14

Biopsies for cholangiocarcinoma

Question 15

How can liver cancer be cured?

Answer 15

Resection (if the area it’s in is resectable)

Question 16

How can HCC be medically treated?

Answer 16

Kinases:

• Sorafenib
• Lenvatinib

Question 17

How do kinases work in HCC?

Answer 17

Prevent cancer cell proliferation

Question 18

What are both HCC and Cholagiocarcinoma resistant to?

Answer 18

Chemo and Radiotherapy

Question 19

When are chemo and radiotherapy used in HCC?

Answer 19

Palliation

Question 20

What’s the prognosis in cholangiocarcinoma?

Answer 20

Very poor

Question 21

How is cholangiocarcinoma treated?

Answer 21

• Palliative ERCP (relieve obstruction)

Question 22

What is a haemangioma?

Answer 22

Common benign tumour of the liver

• No symptoms
• No malignant potential
• No treatment or monitoring needed

Question 23

What is a focal nodular hyperplasia?

Answer 23

Benign liver tumour

• Made of fibrotic tissue
• Asymptomatic with no malignant potential
• Related to oestrogen (common in women on the pill)
• Needs no treatment or monitoring