Liver Tumours

Liver Tumours

Hepatocellular Carcinoma


Pathology:                Primary liver tumour which usually occurs in the presence of cirrhosis


Aetiology:                Cirrhosis and Hepatitis B


Symptoms:               Abdominal Pain, Weight Loss, Jaundice, Right upper quadrant pain, Malaise


Signs:                          Cirrhosis, Jaundice, Ascites,  Hepatomegaly


Investigations:      Bloods: FBC, U&E, Clotting, Raised alfa-fetoprotein

Imaging: Ultrasound Abdomen shows a liver lesion


Treatment:              Medical: Chemotherapy, Radiofrequency ablation, percutaneous ethanol injection,

transarterial chemoembolization – tumour blood supply identified and

chemotherapy infused directly through this artery

Surgical: Liver resection or liver transplantation are curative


Complications:      Biliary obstruction


Prognosis:                Median survival is 6 to 20 months. Resection increases 5 year survival to 40% and

transplantation increases 5 year survival to 75%

























Pathology:                Cancer that arises from epithelial cells of the bile ducts


Aetiology:                 Increased incidence in patients with PSC

Usually patients are asymptomatic until they become jaundiced due to obstruction


Symptoms:               Jaundice, pruritus, weight loss, abdominal pain


Signs:                          Painless jaundice and palpable gall bladder


Investigations:      Bloods: LFTs show an increased bilirubin and ALP

                                        Tumour Markers: CA 19-9 and CEA may be raised

Imaging: Ultrasound Abdomen or MRCP shows dilated bile ducts. ERCP allows for

   tissue biopsy


Treatment:           Medical: ERCP to insert stent in bile duct and relieve Obstruction

Surgical: Resection is rarely possible. Radical hepatectomy and bile duct excision is

   curative. Liver transplantation.


Complications:      Infection of biliary tree and obstruction


Prognosis:           Poor, frequently due to late presentation.

2-8 month survival if treated palliatively.



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