Pathology: Primary liver tumour which usually develops from normal liver cells in individuals that have cirrhosis.
Aetiology: This type of cancer is caused by cirrhosis and infections such as Hepatitis B.
Symptoms: Typical symptoms may include abdominal pain, weight loss, jaundice, right upper quadrant pain, and general malaise.
Signs: Medical indications of this type of liver cancer are cirrhosis, jaundice, ascites, and hepatomegaly.
Investigations: Bloods: FBC, U&E, clotting, and high levels of alfa-fetoprotein.
Imaging: Ultrasound examination of the abdomen may reveal a liver lesion.
Treatment: Medical: The medical options for this type of cancer treatment include chemotherapy, radiofrequency ablation, percutaneous ethanol injection, and transarterial chemoembolization, which involves the identification of the tumour's blood supply and the infusion of chemotherapy directly through this artery.
Surgical: In some cases, liver resection or liver transplantation may be performed to provide a curative option.
Complications: Biliary obstruction may occur as a result of the cancer.
Prognosis: The median survival rate for individuals with this form of cancer is 6 to 20 months, but these survival rates can be increased to 40% if resection is performed and 75% if a liver transplantation is performed.
Pathology: This type of cancer occurs when epithelial cells of the bile ducts become cancerous.
Aetiology: Patients with PSC have an increased risk of developing this form of cancer. Symptoms may remain absent until the cancer blocks the bile ducts and jaundice appears.
Symptoms: Common symptoms of this cancer include jaundice, pruritus, weight loss, and abdominal pain.
Signs: Painless jaundice and a palpable gall bladder may be present.
Investigations: Bloods: A standard LFT will show increased levels of bilirubin and ALP, and tumour markers such as CA 19-9 and CEA may be elevated.
Imaging: An ultrasound abdominal scan or MRCP will reveal any dilated bile ducts.
Endoscopic Retrograde Cholangiopancreatography (ERCP) is an invasive procedure, which allows for tissue biopsy as well as other treatments to be performed.
Infection of the biliary tree and obstruction can be potential complications of ERCP.
The prognosis of ERCP is often poor, frequently due to late presentation. However, if treated palliatively, survival can last from 2 to 8 months.
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