Liver Malignancy and cysts

Question 1

what is more common liver cancer? mets or primary?

Answer 1

mets

Question 2

what is a solid liver lesion in chronic liver disease most likely to be ?

Answer 2

primary liver tumour

Question 3

what is the most common solid liver tumour in non-cirrhosis patients?

Answer 3

haemangioma

Question 4

hypervascular tumour, usually single and small, well demarcated capsule, usually asymptomatic?

Answer 4

haemangioma (massage)

Question 5

“echogenic spot, well demarcated” on US?

Answer 5

haemangioma

Question 6

central scar containing large artery radiating branches to the periphery?

Answer 6

focal nodular hyperplasia

Question 7

what is FNH?

Answer 7

benign nodule formation on normal liver tissue

Question 8

hypervascular mass with central scar?

Answer 8

fnh

Question 9

benign neoplasm composed of normal hepatocytes. No portal tract, no central veins, no bile ducts?

Answer 9

hepatic adenoma

Question 10

hepatic adenoma - can you get pain?

Answer 10

usually asymptomatic but can get RUQ pain

Question 11

What would be seen on US (hepatic adenoma)and CT?

Answer 11

US: filling defect
CT: diffuse arterial enhancement

Question 12

What are hepatic adenomas associated with?

Answer 12

oral contraception and androgenic steroids

Question 13

which one has a malignant risk, adenoma or FNH?

Answer 13

adenoma

Question 14

difference in cellular structure of adenoma and FNH?

Answer 14

adenoma only hepatocytes. FNH contains sinusoids, bile ductules, kupffer cells

Question 15

solitary, unilocular liquid collection lined by an epithelium? what is this and how is it managed?

Answer 15

simple cyst, no follow up needed

Question 16

High fever, leukocytosis, ado pain and complex liver lesion?

Answer 16

liver abcess

Question 17

what would classic history of a liver abcess be?

Answer 17

abdominal/biliary infecton

dental procedure

Question 18

most common malignant tumour?

Answer 18

hepatocellular carcinoma

Question 19

what is the most important risk factor for HCC?

Answer 19

cirrhosis from any cause

Question 20

clinical features?

Answer 20

weight loss ad right upper quadrant pain (most common)
worsening of chronic liver disease
acute liver failure

Question 21

on examination what would you find? (HCC)

Answer 21

signs of cirrhosis, hard enlarged RUQ mass and liver bruit (rare)

Question 22

what is the marker of HCC? GB

Answer 22

Alpha fetaprotein (AFP)

Question 23

where is the most common site for blood borne metastases?

Answer 23

liver

Question 24

best treatment for malignant liver cancer?

Answer 24

liver transplant

Question 25

resection feasible in what circumstance?

Answer 25

small tumours with preserved liver function. However, recurrence rate is high