Liver Tumours Flashcards
Name 4 benign liver tumours
Hemangioma
Focal nodular hyperplasia
Adenoma
Liver cysts
What kind of hepatobiliary cancers are there?
Hepatocellular carcinoma
Cholangiocarcinoma
Metastases
What are hepatic adenomas?
Normally fat containing lesions of the liver
Which lobe are adenomas more likely to occur on?
Right
What common group of drugs are hepatic adenomas associated with?
Oral contraceptives and androgenic steroids
How do you diagnose hepatic adenomas?
Ultrasounds, CT , MRI and maybe FNA (Fine needle aspiration biology)
How do you treat hepatic adenomas?
Stop hormone treatment
Observe every 6 months for 2 years
If there is no regression then surgery is required
What are the three kinds of polycystic liver disease?
Von Myenburg complexes
Polycystic Liver Disease
Autosomal dominant polycystic kidney disease
What causes polycystic liver disease?
Embryonic malformation of the intrahepatic biliary tree.
What is polycystic liver disease?
The occurence of numerous cysts throughout the liver parenchyma
Describe Von Meyenburg complexes (VMC)
Multiple benign cysts throughout the liver.
Usually an incidental finding
What is the difference between polycystic liver disease and autosomal polycystic kidney disease?
PCLD preserves liver function whilst renal failure is rare.
ADPKD causes renal failure and hepatomegaly
How do patients with PcLD present?
Abdominal pain and distension
How do you treat PcLD?
Prevent cyst growth and alleviate symptoms
Transplant or aspiration is sometimes necessary in cases with advanced PCLD, ADPKD or liver failure.
How do patients with a liver abscess present?
Pyrexia
Leukocytosis (High WBC)
Abdominal pain
History may show abdominal or biliary infection or previous dental procedure.
How do you treat liver abscesses?
Broad spectrum antibiotics and drainage
If there is no improvement surgical drainage and 4 week antibiotic therapy is required
What is the biggest risk factor for hepatocellular carcinoma?
Cirrhosis from any cause
Where can HCC metastaise to?
Rest of the liver Portal vein Lymph nodes Lung Bone Brain
What is the tumour marker for HCC?
Alfa feto protein AFP
How do you diagnose HCC?
AFP US CT MRI Biopsy
What are the 5 stages of HCC and how do you treat them?
Stage 0 = Ressection or transplant
Stage A-C =Transplant, ablation, chemotherapy
Stage D = Management of symptoms
What is the best available treatment for HCC?
Liver transplant
