Liver neoplasms (General Surgery EOR - Smarty PANCE)

What is the most common liver cancer?

Metastatic disease outnumbers primary tumors 20:1; primary site is usually the GI tract

What is the most common primary malignant liver tumor?

Hepatocellular carcinoma (hepatoma)

What is the most common primary benign liver tumor?

Hemangioma

What lab tests comprise the workup for liver metastasis?

LFTs (AST and alkaline phosphatase are most useful), CEA for suspected primary colon cancer

What are the associated imaging studies when evaluating a patient for liver cancer?

CT scan, ultrasound, A-gram

What is a right hepatic lobectomy?

Removal of the right lobe of the liver (i.e., all tissue to the right of Cantle's line is removed)

What is a left hepatic lobectomy?

Removal of the left lobe of the liver (i.e., removal of all the liver tissue to the left of Cantle's line)

What is a right trisegmentectomy?

Removal of all the liver tissue to the right of the falciform ligament

What are the three common types of primary benign liver tumors?

1. Hemangioma

2. Hepatocellular adenoma

3. Focal nodular hyperplasia

What are the four common types of primary malignant liver tumors?

1. Hepatocellular carcinoma (hepatoma)

2. Cholangiocarcinoma (when intrahepatic)

3. Angiosarcoma (associated with chemical exposure) 4

. Hepatoblastoma (most common in infants and children)

What chemical exposures are risk factors for angiosarcoma?

Vinyl chloride, arsenic, thorotrast contrast

What is a "hepatoma"?

Hepatocellular carcinoma

What are the other benign liver masses?

Benign liver cyst, bile duct hamartomas, bile duct adenoma

What is a liver "hamartoma"?

White hard nodule made up of normal liver cells