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Medicine > Liver Neoplasm > Flashcards

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
Q

Fill in the blank: Nodular regenerative hyperplasia is characterized by ______ of the hepatic parenchyma.

A

benign transformation

26
Q

What are the benign liver tumors?

A
  • Haemangioma
  • Focal nodular hyperplasia
  • Adenoma
  • Liver cysts
  • Nodular regenerative hyperplasia
27
Q

What is the diagnosis method for Haemangioma?

A
  • USS: echogenic spot
  • CT: venous enhancement
  • MRI: high intensity area
28
Q

What is the treatment for large symptomatic Haemangiomas?

A

Surgical resection.

29
Q

What demographic is most affected by Hepatic Adenoma?

A

Women aged 20-44 years.

30
Q

What is the usual management for Hepatic Adenoma?

A

Stop hormones or OCPs and observe every 6 months for 2 years.

31
Q

What is the characteristic feature of Focal Nodular Hyperplasia (FNH) on imaging?

A

Hypervascular mass with a central scar.

32
Q

What is the common clinical presentation of focal nodular hyperplasia (FNH)?

A

Usually asymptomatic but may have right upper quadrant (RUQ) pain

FNH may rarely present with rupture, hemorrhage, or malignant transformation.

33
Q

What imaging technique shows a nodule with varying echogenicity for diagnosing FNH?

A

Ultrasound (USS)

This is used to visualize the characteristics of the nodule.

34
Q

What is the characteristic finding on CT for focal nodular hyperplasia?

A

Hypervascular mass with central scar

This central scar is a key feature in differentiating FNH from other liver lesions.

35
Q

What does MRI reveal in cases of focal nodular hyperplasia?

A

Iso or hypo intense lesion

This imaging helps in confirming the diagnosis.

36
Q

What is the typical treatment recommendation for large focal nodular hyperplasia (FNH)?

A

Surgical removal to prevent rupture

However, rupture is uncommon.

37
Q

What is the most common benign primary liver tumor?

A

Haemangioma

The occurrence in the general population ranges from 0.4-20%.

38
Q

What type of cells do haemangiomas arise from?

A

Endothelial cells

These cells line blood vessels.

39
Q

What is a common feature of small haemangiomas regarding treatment?

A

Do not require follow-up imaging or treatment

They are usually asymptomatic.

40
Q

What age group is more commonly affected by focal nodular hyperplasia?

A

Young women between the ages of 20 and 30 years

FNH has no relationship with sex hormones.

41
Q

True or False: Haemangiomas usually present with significant symptoms.

A

False

They are usually asymptomatic but may cause RUQ pain, early satiety, and signs of portal hypertension in giant cases.

42
Q

What is the histological finding in FNAC for focal nodular hyperplasia?

A

Normal hepatocytes and Kupffer cells with central core

This finding helps in confirming the diagnosis of FNH.

43
Q

What is the potential complication of large haemangiomas?

A

RUQ pain, early satiety, and signs of portal hypertension

These symptoms may occur with giant haemangiomas.

44
Q

The best diagnostic tests for the detection of hepatic hemangioma are

A

CT scan
MRI

45
Q

Fine needle aspiration or biopsy is needed in the diagnosis of benign hemangioma T/F

A

False

46
Q

The treatment methods for benign hepatic hemangioma include…

A

Small no treatment
Large-surgical resection

Medicine (17 decks)

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