Liver Lesions Flashcards
What is the most common benign tumour of the liver? What does it consist of?
Haemoangioma
Dilated blood vessels
Is treatment required for haemoangioma?
No
What is focal nodular hyperplasia?
Benign nodule formation of normal liver tissue
Is treatment required focal nodular hyperplasia?
None required
What is a hepatic adenoma?
Benign neoplasm composed of normal hepatocytes with no portal tracts, central veins or bile ducts
What are hepatic adenomas associated with?
The oral contraceptive pill and anabolic steroids
Presentation of hepatic adenoma?
May have RUQ pain, rupture, haemorrhage or malignant transformation (very rare) usually though patients are asymptomatic
When is treatment required for hepatic adenoma? What is this?
Resection is required only for those with tumours more than 5cm in diameter, tumours that don’t shrink after discontinuation of oral contraceptive or those who are symptomatic
What is fibrolamellar carcinoma?
Liver cell cancer that presents in young people, not associated with cirrhosis with no raise in AFP that can usually be surgically resected
Most common primary malignancy of the liver?
Hepatocellular carcinoma
Most important risk factor for HCC?
Cirrhosis from any cause
Presentation of HCC?
Weight loss, anorexia, fever, right hypochondriac pain and ascites. Rapid development of these symptoms in a cirrhotic patient is suggestive of HCC. On examination an enlarged, irregular, tender liver may be felt.
What is a marker of HCC?
Serum alfa-fetoprotein
Treatment of hepatocellular carcinoma?
Liver transplant is the best available treatment. Resection is only possible if the lesion is small and there is preserved liver function. Chemoembolisation can be done in patients with early cirrhosis (chemo is injected selectively into the hepatic artery) Sorafenib prolongs survival. Palliation measures are local ablation.
