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Liver tumours
Benign
Malignant-
Primary
Secondary
BENIGN –
Hemangioma
Hepatic adenoma
Primary-
Hepatocellular carcinoma
(HCC/Hepatoma)
Cholangiocarcinoma
Hepatoblastoma
Secondary- Abdominal -
Gastrointestinal tract
Gall bladder
Common bile duct
Kidney, pancrease
Extra abdominal-
Breast, Lung .
Melanoma, Thyroid.
Benign tumours of the liver-
Two times >(common) malignant
tumour, 20% of population.
solitary or multicentric.
compressibility - diagnostic.
No malignant potential.
complications-
Bleeding
Rupture.
Thrombosis.
DIC.
Infection.
MRI- Diagnostic
U/S and CT - confirmative.
Treatment-
Stop oral contraceptive pills.
Surgical resection.
Focal nodular hyperplasia-
2nd most common.
Solitary nodule.
Focal overgrtowth of functioning liver tissue.
Harmless.
Hepatic cells as well as Kupffer cells (Characteristic).
C T scan- Central scar with stellate
distribution.
No treatment.
Primary malignant tumour of liver-
1. Hepato-cellular carcinoma-80%.
2.Cholangiocarcinoma.
Gastrointestinal bleeding- 10 %
Paraneoplastic syndrome.
Spread of tumour
Direct infiltration- To diaphragm and
neighouring structures.
.
Differential diagnosis-
1.Secondaries in liver.
6. Liver biopsy.
8.Laparoscopic evaluation.
Treatment-
Definitive- Hemihepatectomy.
Total hepatectomy with liver
transplantation.
Palliative – Radiofrequency
ablation.
Percutaneous ethanol or acetic acid
injection.
Adriamycin/Cisplatin
Intra arterial embolisation.
Adjuvant -
- Systemic chemotherapy.
- Adriamycin, Cisplatin, 5-
Flurouracil.
Secondaries in liver-
Commnest malignant tumour.
Primary:secondary- 1:20.
Loss of appetite and weight.
Jaundice
Hepatomegaly with multiple, hard,
nodules showing UMBLICATION due to
central necrosis.
Ascitis.
Recto-vesical secondaries- Blumer shelf.