Malignant Liver Lesions Flashcards
What is hepatocellular carcinoma?
Malignant primary liver cell cancer
Who gets hepatocellular carcinoma?
More common in men
Cirrhosis (Hep B causes, alcohol, toxins, others)
Presentation of hepatocellular carcinoma?
Wt loss & RUQ pain Asymptomatic Acute liver failure Signs of cirrhosis Hard enlarged mass RUQ Liver bruit (rare)
Diagnosis of hepatocellular carcinoma?
AFP (Alfa fetprotein) elevation Clinical presentation Labs of liver cirrhosis US MRI Biopsy
What is AFA?
HCC tumour marker
Treatment of HCC?
Liver transplant- if single tumour of <5cm, or 3 tumours <3cm.
Resection
Local ablation (temporary)
Chemoembolization (TACE) - only for patients with early cirrhosis
Systemic chemotherapy:sorafenib
Mets of HCC to?
Rest of liver Portal Vein Lymph nodes Lung Bone Brain
Who gets fibrolamellar carcinoma of the liver?
Young patients
Unrelated to cirrhosis
AFP is normal
Types of metastatic liver cancer?
Hepatocellular carcinoma
Fibrolamellar carcinoma of liver
Cholangiocarcinoma
How is fibro-lamellar carcinoma of liver diagnosed?
CT shows stellate scar with radial septa showing persistent enhancement
Treatment of fibro-lamellar carcinoma of liver?
Surgical resection
Transplantation
TACE- unresectable tumours
Primary places for secondary liver mets?
Colon Breast Lung Stomach Pancreas Melanoma
Diagnosis of secondary liver mets?
Imaging or FNA
What is cholangiocarcinoma?
Second most common hepatobiliary cancer
Presentation of cholangiocarcinoma?
Late Jaundice Wt loss Anorexia Lethargy 50% have lymph node mets
