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Gastro > Malignant Liver lesions > Flashcards

Malignant Liver lesions Flashcards

1
Q

What are the 5 main malignant liver tumours

A 
Hepatocellular carcinoma (HCC)
Fibro-lamellar carcinoma of the liver 
Hepatoblastoma
Intrahepatic cholangiocarcinoma 
Metastases
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2
Q

What is the most common primary liver cancer

A

Hepatocellular carcinoma

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3
Q

Who is likely to have HCC

A

Saudi Men

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4
Q

What is the most important risk factor for HCC

A

Cirrhosis

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5
Q

What 4 things can cause HCC

A

Hep B
Hep C
Alcohol
Aflatoxin

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6
Q

What is aflatoxin

A

Mould on peanuts

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7
Q

Is HCC usually symptomatic or asymptomatic?

A

Asymptomatic

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8
Q

What are the 2 common presentations for HCC in those who are symptomatic

A

Weight loss and RUQ pain

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9
Q

Where are the 6 common places for HCC metastases

A 
Rest of the lvier,
Via the portal vein
Lymph nodes
Lung
Bone 
Brain
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10
Q

What is the most common protein marker for HCC

A

Alfa feto protein (AFP)

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11
Q

What is the problem with testing AFP?

A

An elevation is only seen in 70% of the patients

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12
Q

How can we diagnose HCC

A 
Elevated AFP
US
Triphasic CT
MRI
Biopsy
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13
Q

What is the prognosis of HCC

A

Depends on the tumour size and whether there is extrahepatic spread
Underlying liver disease

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14
Q

What is the best available treatment for HCC

A

Liver transplantation

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15
Q

When are we able to do a liver transplantation for patients with HCC

A

If there is only a single tuour which is less than 5cm or if there are less than 3 tumours less than 3cm each

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16
Q

When is HCC resection feasible

A

For small tumours with preserved liver function (no jaundice or portal Hypertension

17
Q

What can we do for a patient with non resectable HCC

A

Local Ablation

18
Q

What type of technique is local ablation

A

Palliative

19
Q

What does radio frequency ablation involve

A

Putting devices into the liver and cooking boiling or killing them with alcohol

20
Q

How is chemoembolisation performed

A

Inject chemotherapy into the hepatic artery

21
Q

Who is most likely to get fibro-lamellar carcinoma

A

Young patients - 5-35

22
Q

What is fibro-lamellar carcinoma not related to

A

Cirrhosis

23
Q

What does a CT show in fibro-lamellar Carcinoma

A

Stellate scar with radial septa showing persistant enhancement

24
Q

Where is the most common site for blood born metastases

A

Liver

25
Q

Where are the common primaries metastases

A 
Colon
Breast
Lung
Stomach
Pancreas
Melanoma
26
Q

How can we diagnose secondary liver metastases

A

Imaging or FNA

27
Q

What does treatment depend on for secondary liver metastases

A

The primary cancer

Gastro (67 decks)

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