liver tumors basic

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1、LiverTumorsAymanAbdoMD,AmBIM,FRCPCObjectiveIdentifythemostimportantfeaturesofcommonbenignlivertumorsKnowtheriskfactors,diagnosis,andmanagementofhepatocellularcarcinomaClassificationHemangiomaFocalnodularhyperplasiaAdenomaLivercystsPrimarylivercancersHepatocellularcar

2、cinomaFibrolamellarcarcinomaHepatoblastoma2.MetastasesBenignMalignantBenignLiverLesionsHemangiomaFocalnodularhyperplasiaAdenomaCystsHemangiomaClinicalFeaturesThecommonestlivertumor5%ofautopsiesUsuallysinglesmallWelldemarcatedcapsuleUsuallyasymptomaticHemangiomaDiagno

3、sisandManagementDiagnosisUS:echogenicspot,welldemarcatedCT:venousenhancementfromperipherytocenterMRI:highintensityareaNoneedforFNATreatmentNoneedfortreatmentCT/HemangiomaFocalNodularHyperplasia(FNH)ClinicalFeaturesBenignnoduleformationofnormallivertissueCentralstell

4、atescarMorecommoninyoungandmiddleagewomenNorelationwithsexhormonesUsuallyasymptomaticMaycauseminimalpainFocalNodularHyperplasia(FNH)DiagnosisandManagementDiagnosis:US:NodulewithvaryingechogenicityCT:HypervascularmasswithcentralscarMRI:isoorhypointenseFNA:Normalhepat

5、ocytesandKupffercellswithcentralcore.Treatment:NotreatmentnecessaryPregnancyandhormonesOKCT/FNHHepaticAdenomaClinicalfeaturesBenignneoplasmcomposedofnormalhepatocytesnoportaltract,centralveins,orbileductsMorecommoninwomenAssociatedwithcontraceptivehormonesUsuallyasym

6、ptomaticbutmayhaveRUQpainMatpresentswithrupture,hemorrhage,ormalignanttransformation(veryrare)HepaticAdenomaDiagnosisandManagementDXUS:fillingdefectCT:DiffusearterialenhancementMRI:hypoorhyperintenselesionFNA:maybeneededTxStophormonesObserveevery6mfor2yIfnoregression

7、thensurgicalexcisionAdenomaLiverCystsMaybesingleormultipleMaybepartofpolycystickidneydiseasePatientsoftenasymptomaticNospecificmanagementrequiredHydatedcystMalignantLiverLesionsMalignantLiverTumorsHepatocellularcarcinoma(HCC)Fibro-lamellarcarcinomaoftheliverHepatobla

8、stomaIntrahepaticcholangiocarcinomaOthersHCC:IncidenceThemostcommonprimarylivercancerThemostcommontumorinSaudimenIncreasinginUSanda