Malignant lesions of Liver

Question 1

initial management of liver adenomas less than 5 cm

Answer 1

stop oral contraceptives or anabolic steroids and monitor

Question 2

management of liver adenomas greater than 5cm

Answer 2

resect

Question 3

characteristics of liver metastasis on ultrasound

Answer 3

hyperechoic surrounded by hypoechoic rim (targetoid appearance)

Question 4

radiologic features of hepatic metastasis on

Answer 4

hypoattenuating, multiple, diffuse; hypodense; ehnaces minimally on arterial phase

Question 5

radiologic features of hemangioma of liver

Answer 5

nodular peripheral enhancement/peripheral “puddling” on arterial phase with centripetal fill-in on subsequent phases

Question 6

radiologic features of hepatic adenoma

Answer 6

central changes of recent hemorrhage

Question 7

radiologic features of FNH

Answer 7

hypodense with central scar on noncontrast; hyperdense on arterial phase; isodense on portal phase

Question 8

radiologic features of hepatocellular carcinoma

Answer 8

increased vascularity compared with surrounding liver parenchyma on arterial phase (bright); quick washout of contrast on late phases; heterogenous; poorly circumscribed

Question 9

radiologic features of cholangiocarcinoma

Answer 9

hypodense with peripheral rim enhancement, biliary dilatation, contrast enhancement on delayed images

Question 10

eligibility for liver transplant in patients with HCC based on Milan criteria:

Answer 10

single tumor less than 5cm or as many as three tumors <3cm in size; no evidence of gross vascular invasion, no distant metastasis

Question 11

most common cause of HCC

Answer 11

viral hepatitis

Question 12

True or False. For unresectable hepatocellular carcinoma, sorafenib is better than atezolizumab combined with bevacizumab overall and for progression free survival

Answer 12

false. atezolizumab plus bevacizumab are better than sorafenib

Question 13

Common causes of chylous ascites in the US

Answer 13

abdominal malignancy, lymphatic abnormalities, and cirrhosis

malignancy, particularly lymphoma, is the most common cause in adults

Question 14

eligibility for liver transplant in patients with HCC based on the UCSF criteria:

Answer 14

single tumor less than 6.5cm or as many as three tumors < 4.5cm with total diameter less than 8cm; no evidence of gross vascular invasion and no distant metastasis