Liver Tumors

Question 1

Simple liver cysts

Answer 1

Usually asymptomatic
But can be large and symptomatic from mass effect
Common
May be multiple
Smooth wall, homogenous

Question 2

Complex liver cysts

Answer 2

Septations and thick walls

Question 3

Hemangioma

Answer 3

Most common liver tumor
Endothelial cell origin
Collagen scaffold (no rupture)
May be multiple
Usually asymptomatic
Peripheral in filling on imaging (contrast stays in longer)

Question 4

Focal Nodular Hyperplasia

Answer 4

Normal liver cells/all components in a disorganized fashion
Hyperplasia of normal liver cells
Central scar present
Second most common liver tumor
Usually of no clinical significance
Can be hard to tell bw this and adenoma

Question 5

Adenoma

Answer 5

Sheets of hepatocytes
Benign neoplasm
Much less common
More common in females (OCP)
May be symptomatic
Large, fleshy tumors
Retains contrast throughout

Question 6

2 risks with large liver cell adnoma

Answer 6

Rupture (especially in pregnancy)

Malignant degeneration

Question 7

Hepatocellular carcinoma

Answer 7

Common malignancy worldwide
Usually associated with cirrhosis (HBV, HCV, hemochromatosis)
Tumor marker: alpha fetal protein
Surgical resection is tx of choice

Question 8

Cholangiocarcinoma

Answer 8

Malignant neoplasm of the bile duct epithelium
Usually involves major bile ducts (jaundice)
Can also aris from intrahepatic ducts
Surgical resection tx of choice

Question 9

2 main risks with liver biopsy

Answer 9

If its a hemangioma it can bleed

If its a cancer you can disseminate it

Question 10

When is systemic chemo useful in liver tumors?

Answer 10

Metastasis
Intermediate benefit for HCC
Poor outcomes with cholangiocarcinoma