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Liver Neoplasm Flashcards

1
Q

What is polycystic liver disease?

A

An inherited condition (autosomal dominant) often found in association with renal cysts.

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2
Q

What is the typical presentation of patients with polycystic liver disease?

A

Most patients remain asymptomatic with preserved liver function and do not require surgical intervention.

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3
Q

What is the technique of fenestration in treating liver cysts?

A

A technique that combines aspiration with surgical deroofing of a cyst in a single procedure.

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4
Q

What is chemoembolization?

A

Injecting a chemotherapeutic agent selectively in the hepatic artery, followed by an embolic agent.

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5
Q

True or False: Embolization can be done alone or combined with selective intra-arterial chemotherapy (TACE).

A

True.

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6
Q

What are the indications for Radiofrequency Ablation (RFA)?

A

Very early stage HCC not amenable to resection, early stage HCC not suitable for liver transplantation, patients with waiting times > 3 months.

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7
Q

What is the procedure for Percutaneous Ethanol Injection (PEI)?

A

Injection of absolute alcohol directly into tumor nodules under ultrasound or CT guidance.

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8
Q

Fill in the blank: The best survival rates for PEI are obtained for tumors ______ cm and less than 3 lesions.

A

less than 3

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9
Q

What is the purpose of embolization in liver treatment?

A

To induce ischemic tumor necrosis via acute hepatic arterial occlusion.

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10
Q

What is Sorafenib?

A

An oral multikinase inhibitor recommended in patients with advanced HCC.

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11
Q

What is the recommended dosage of Sorafenib?

A

400 mg PO twice daily.

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12
Q

What is the most common age group for Fibro-Lamellar Carcinoma?

A

Young patients aged 5-35 years.

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13
Q

What are common primary cancers that metastasize to the liver?

A
  • Colon
  • Breast
  • Lung
  • Stomach
  • Pancreas
  • Melanoma
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14
Q

What percentage of the population is affected by simple hepatic cysts?

A

2-7%.

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15
Q

True or False: Most simple hepatic cysts are asymptomatic.

A

True.

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16
Q

What are treatment options for symptomatic simple cysts?

A
  • Aspiration with or without sclerosants
  • Laparoscopic unroofing
  • Cystojejunostomy
  • Resection
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17
Q

What are the universally accepted screening tools for HCC?

A
  • Serum α-fetoprotein
  • Abdominal ultrasound or CT scan or MRI
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18
Q

What are the criteria for liver transplantation in HCC patients?

A
  • Non-resectable tumor confined to the liver
  • Single tumor ≤ 5 cm or maximum of 3 tumors each < 3 cm
  • No evidence of large vessel invasion or extra-hepatic spread
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19
Q

What are the survival rates for hepatic resection in HCC patients?

A
  • 1 year: 97%
  • 3 years: 84%
  • 5 years: 26%-57%
20
Q

What is the incidence of HCC globally?

A

HCC is the 5th commonest cancer in the world and the 3rd commonest cause of cancer death.

21
Q

What is a key symptom of HCC?

A

Weight loss and RUQ pain.

22
Q

What are the treatment options for HCC?

A
  • Surgery (Hepatic resection, Liver transplantation)
  • Loco-regional therapies (PEI, RFA, Microwave ablation, Cryoablation, TACE)
23
Q

What is the most important risk factor for HCC?

A

Cirrhosis from any cause.

24
Q

What is the role of AFP in HCC diagnosis?

A

AFP is a tumor marker for HCC; levels > 200 ng/ml plus imaging evidence is highly specific for diagnosis.

25
Fill in the blank: Nodular regenerative hyperplasia is characterized by ______ of the hepatic parenchyma.
benign transformation
26
What are the benign liver tumors?
* Haemangioma * Focal nodular hyperplasia * Adenoma * Liver cysts * Nodular regenerative hyperplasia
27
What is the diagnosis method for Haemangioma?
* USS: echogenic spot * CT: venous enhancement * MRI: high intensity area
28
What is the treatment for large symptomatic Haemangiomas?
Surgical resection.
29
What demographic is most affected by Hepatic Adenoma?
Women aged 20-44 years.
30
What is the usual management for Hepatic Adenoma?
Stop hormones or OCPs and observe every 6 months for 2 years.
31
What is the characteristic feature of Focal Nodular Hyperplasia (FNH) on imaging?
Hypervascular mass with a central scar.
32
What is the common clinical presentation of focal nodular hyperplasia (FNH)?
Usually asymptomatic but may have right upper quadrant (RUQ) pain ## Footnote FNH may rarely present with rupture, hemorrhage, or malignant transformation.
33
What imaging technique shows a nodule with varying echogenicity for diagnosing FNH?
Ultrasound (USS) ## Footnote This is used to visualize the characteristics of the nodule.
34
What is the characteristic finding on CT for focal nodular hyperplasia?
Hypervascular mass with central scar ## Footnote This central scar is a key feature in differentiating FNH from other liver lesions.
35
What does MRI reveal in cases of focal nodular hyperplasia?
Iso or hypo intense lesion ## Footnote This imaging helps in confirming the diagnosis.
36
What is the typical treatment recommendation for large focal nodular hyperplasia (FNH)?
Surgical removal to prevent rupture ## Footnote However, rupture is uncommon.
37
What is the most common benign primary liver tumor?
Haemangioma ## Footnote The occurrence in the general population ranges from 0.4-20%.
38
What type of cells do haemangiomas arise from?
Endothelial cells ## Footnote These cells line blood vessels.
39
What is a common feature of small haemangiomas regarding treatment?
Do not require follow-up imaging or treatment ## Footnote They are usually asymptomatic.
40
What age group is more commonly affected by focal nodular hyperplasia?
Young women between the ages of 20 and 30 years ## Footnote FNH has no relationship with sex hormones.
41
True or False: Haemangiomas usually present with significant symptoms.
False ## Footnote They are usually asymptomatic but may cause RUQ pain, early satiety, and signs of portal hypertension in giant cases.
42
What is the histological finding in FNAC for focal nodular hyperplasia?
Normal hepatocytes and Kupffer cells with central core ## Footnote This finding helps in confirming the diagnosis of FNH.
43
What is the potential complication of large haemangiomas?
RUQ pain, early satiety, and signs of portal hypertension ## Footnote These symptoms may occur with giant haemangiomas.
44
The best diagnostic tests for the detection of hepatic hemangioma are
CT scan MRI
45
Fine needle aspiration or biopsy is needed in the diagnosis of benign hemangioma T/F
False
46
The treatment methods for benign hepatic hemangioma include...
Small no treatment Large-surgical resection

Medicine (18 decks)

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