Podcast
Questions and Answers
What imaging modality is commonly used to identify liver neoplasms?
What imaging modality is commonly used to identify liver neoplasms?
What is the most frequent type of benign liver neoplasm?
What is the most frequent type of benign liver neoplasm?
Which of the following is NOT a characteristic of cavernous hemangiomas?
Which of the following is NOT a characteristic of cavernous hemangiomas?
What does the term "incidental finding" mean in the context of liver neoplasms?
What does the term "incidental finding" mean in the context of liver neoplasms?
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Which of the following is a primary cancer that commonly metastasizes to the liver?
Which of the following is a primary cancer that commonly metastasizes to the liver?
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Which type of benign liver neoplasm is most commonly associated with oral contraceptives?
Which type of benign liver neoplasm is most commonly associated with oral contraceptives?
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Which of the following is true regarding the treatment of benign liver neoplasms?
Which of the following is true regarding the treatment of benign liver neoplasms?
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What is the most prevalent type of liver cancer originating from parenchymal cells?
What is the most prevalent type of liver cancer originating from parenchymal cells?
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Which of the following statements is TRUE about liver cancer metastasis?
Which of the following statements is TRUE about liver cancer metastasis?
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Which of the following conditions is NOT a benign liver neoplasm?
Which of the following conditions is NOT a benign liver neoplasm?
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Which of the following is NOT a risk factor associated with the development of Hepatocellular Carcinoma in parts of Asia and Africa?
Which of the following is NOT a risk factor associated with the development of Hepatocellular Carcinoma in parts of Asia and Africa?
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What is the preferred imaging method for diagnosing Hepatocellular Carcinoma?
What is the preferred imaging method for diagnosing Hepatocellular Carcinoma?
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At what level of α-feta protein is considered significant in the diagnosis of Hepatocellular Carcinoma?
At what level of α-feta protein is considered significant in the diagnosis of Hepatocellular Carcinoma?
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Which of the following is NOT a clinical finding associated with Hepatocellular Carcinoma?
Which of the following is NOT a clinical finding associated with Hepatocellular Carcinoma?
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Which of the following is NOT a risk factor associated with the development of Pancreatic Cancer?
Which of the following is NOT a risk factor associated with the development of Pancreatic Cancer?
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What percentage of pancreatic cancers are located in the head of the pancreas?
What percentage of pancreatic cancers are located in the head of the pancreas?
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What is the clinical sign associated with an enlarged, nontender gallbladder and mild painless jaundice?
What is the clinical sign associated with an enlarged, nontender gallbladder and mild painless jaundice?
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Which of the following is NOT a recommended screening measure for Hepatocellular Carcinoma?
Which of the following is NOT a recommended screening measure for Hepatocellular Carcinoma?
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What is the approximate 5-year survival rate for Hepatocellular Carcinoma?
What is the approximate 5-year survival rate for Hepatocellular Carcinoma?
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Which of the following is NOT a common manifestation of Pancreatic Cancer?
Which of the following is NOT a common manifestation of Pancreatic Cancer?
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Which of the following is NOT a risk factor for colorectal cancer?
Which of the following is NOT a risk factor for colorectal cancer?
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Which type of polyp is associated with a higher risk of developing into colorectal cancer?
Which type of polyp is associated with a higher risk of developing into colorectal cancer?
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Which symptom is more likely to be present in patients with proximal colon cancer?
Which symptom is more likely to be present in patients with proximal colon cancer?
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Which of the following laboratory test is most likely to indicate metastatic colorectal cancer?
Which of the following laboratory test is most likely to indicate metastatic colorectal cancer?
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Which of the following features would classify a polyp as 'advanced'?
Which of the following features would classify a polyp as 'advanced'?
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What is the recommended approach for screening for colorectal cancer?
What is the recommended approach for screening for colorectal cancer?
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Which of the following is NOT a sign or symptom of colorectal cancer?
Which of the following is NOT a sign or symptom of colorectal cancer?
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Which statement about colorectal cancer is TRUE?
Which statement about colorectal cancer is TRUE?
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A patient presents with an "Apple Core" lesion on a barium study. Which of the following statements is TRUE about this finding and its significance?
A patient presents with an "Apple Core" lesion on a barium study. Which of the following statements is TRUE about this finding and its significance?
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A patient undergoing colorectal cancer screening has a life expectancy of 8 years. According to the information provided, what is the most appropriate course of action for this patient regarding screening?
A patient undergoing colorectal cancer screening has a life expectancy of 8 years. According to the information provided, what is the most appropriate course of action for this patient regarding screening?
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A patient is diagnosed with stage III colorectal cancer. Which of the following statements regarding treatment is MOST ACCURATE?
A patient is diagnosed with stage III colorectal cancer. Which of the following statements regarding treatment is MOST ACCURATE?
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Which of the following statements is TRUE regarding colorectal cancer screening with fecal immunochemical testing (FIT)?
Which of the following statements is TRUE regarding colorectal cancer screening with fecal immunochemical testing (FIT)?
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A patient with a family history of colorectal cancer has a high risk for developing the disease. What is the recommended screening strategy for this patient?
A patient with a family history of colorectal cancer has a high risk for developing the disease. What is the recommended screening strategy for this patient?
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Which of the following statements accurately reflects the prognosis of pancreatic cancer?
Which of the following statements accurately reflects the prognosis of pancreatic cancer?
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A patient presents with stools that have a silvery appearance. What is the most likely explanation for this symptom based on the provided information?
A patient presents with stools that have a silvery appearance. What is the most likely explanation for this symptom based on the provided information?
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What diagnostic tests should be considered when evaluating a suspected case of pancreatic cancer?
What diagnostic tests should be considered when evaluating a suspected case of pancreatic cancer?
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In the context of pancreatic cancer staging, what does T3 represent?
In the context of pancreatic cancer staging, what does T3 represent?
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What is the rationale behind referring patients with suspected pancreatic cancer to a specialist?
What is the rationale behind referring patients with suspected pancreatic cancer to a specialist?
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Why is chemotherapy often disappointing in the treatment of metastatic pancreatic cancer?
Why is chemotherapy often disappointing in the treatment of metastatic pancreatic cancer?
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What is the primary rationale for performing endoscopic stenting of the bile duct in patients with pancreatic cancer?
What is the primary rationale for performing endoscopic stenting of the bile duct in patients with pancreatic cancer?
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Which of the following statements regarding the treatment of pancreatic cancer is accurate?
Which of the following statements regarding the treatment of pancreatic cancer is accurate?
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Flashcards
Cirrhosis Complications
Cirrhosis Complications
Cirrhosis often leads to complications affecting liver function and health.
Liver Imaging
Liver Imaging
CT or MRI scans used to visualize liver conditions and detect neoplasms.
Benign Neoplasms
Benign Neoplasms
Non-cancerous growths in the liver like cavernous hemangiomas and hepatic adenomas.
Cavernous Hemangiomas
Cavernous Hemangiomas
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Malignant Neoplasms
Malignant Neoplasms
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Hepatic Adenomas
Hepatic Adenomas
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Focal Nodular Hyperplasia
Focal Nodular Hyperplasia
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Benign Liver Neoplasms Treatment
Benign Liver Neoplasms Treatment
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Hepatocellular Carcinomas
Hepatocellular Carcinomas
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Cholangiocarcinomas
Cholangiocarcinomas
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CA 19-9 tumor marker
CA 19-9 tumor marker
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Amylase and Lipase
Amylase and Lipase
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Occult blood in stool
Occult blood in stool
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TNM Classification
TNM Classification
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T1 Tumor
T1 Tumor
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T4 Tumor
T4 Tumor
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Poor prognosis
Poor prognosis
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When to refer
When to refer
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Colorectal Cancer
Colorectal Cancer
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Adenomatous Polyps
Adenomatous Polyps
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Serrated Polyps
Serrated Polyps
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Advanced Polyps
Advanced Polyps
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Colonoscopy
Colonoscopy
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Colorectal Cancer Risk Factors
Colorectal Cancer Risk Factors
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CBC and Anemia
CBC and Anemia
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Carcinoembryonic Antigen (CEA)
Carcinoembryonic Antigen (CEA)
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Cirrhosis
Cirrhosis
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Alpha-fetoprotein (AFP)
Alpha-fetoprotein (AFP)
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Risk factors for Hepatocellular Carcinoma
Risk factors for Hepatocellular Carcinoma
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Pancreatic Cancer
Pancreatic Cancer
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Courvoisier's sign
Courvoisier's sign
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Late symptoms of Pancreatic Cancer
Late symptoms of Pancreatic Cancer
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Chronic Hepatitis B
Chronic Hepatitis B
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Screening recommendations
Screening recommendations
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Liver biopsy
Liver biopsy
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Apple Core Lesion
Apple Core Lesion
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Colonoscopy Usage
Colonoscopy Usage
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TNM Staging System
TNM Staging System
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Colorectal Cancer Screening
Colorectal Cancer Screening
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Chemotherapy in Colorectal Cancer
Chemotherapy in Colorectal Cancer
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Study Notes
Liver Neoplasms
- Liver neoplasms are often complications of cirrhosis.
- Diagnosis relies on imaging (CT or MRI) combined with biopsy confirmation.
- Two categories exist: benign and malignant.
Benign Liver Neoplasms
- Cavernous Hemangiomas: The most common benign liver neoplasm. Often an incidental finding on imaging.
- Masses of small blood vessels. Hormone treatments (OCPs) sometimes increase their size.
- Typically managed by observation for symptoms or growth. Surgery is rarely necessary.
- Hepatic Adenomas: Commonly occur in the 3rd and 4th decades of life. Often linked to oral contraceptives (OCPs).
- Abdominal pain can result from tumor necrosis or hemorrhage.
- Focal Nodular Hyperplasia: Another benign liver tissue type, occurring across all ages. Typically found in women.
- Likely not linked to oral contraceptives. Often asymptomatic.
Malignant Liver Neoplasms
- Can be primary (originating in the liver) or metastatic (spread from other cancers).
- The liver is a common metastatic site for cancers elsewhere, like lung and breast.
- Hepatocellular Carcinomas (HCC): Originate from parenchymal cells. Account for 85% of liver cancers globally.
- HCC is a significant cause of cancer-related deaths worldwide.
- Cholangiocarcinomas: Originate from ductal cells. Represent less than or equal to 15% of liver cancers.
Hepatocellular Carcinoma (HCC)
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Risk Factors (Western World): Cirrhosis, male gender, age 55+, Hepatitis C infection, Obesity and Diabetes Mellitus, Family history, and Ethnicity (Asian & Hispanic)
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Risk Factors (Global/Other parts of the world): Alcohol abuse and Hepatitis B infection.
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Clinical Findings: Cachexia, Weakness, Weight loss, Ascites, Hepatic tenderness, Bruit/friction rub. In some regions like Africa, younger age groups may present with a rapidly growing abdominal mass.
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Laboratory Findings: Elevated alpha-fetoprotein (AFP) level (> 200 ng/mL) in about 70% of cases. Leukocytosis (increased white blood cell count) is also observed.
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Imaging: CT or MRI (with contrast) is the preferred imaging choice. Liver biopsy is often diagnostic but carries risk.
Pancreatic Neoplasms
- Pancreatic Cancer Symptoms: Obstructive jaundice (may be painless), Enlarged gallbladder(may be painful), Upper abdominal pain (radiating to the back), weight loss, and thrombophlebitis (often late symptoms).
- Pancreatic Cancer Characteristics: Adenocarcinoma is the most common type, accounting for 75% of cases, which usually occurs in the head of the pancreas. Tumor in the body and tail of the pancreas is 25%. The disease accounts for 2% of all cancers and 5% of cancer deaths.
Pancreatic Cancer Risk Factors
- Age
- Tobacco use (thought to cause 20-25% of cases)
- Heavy alcohol use
- Obesity
- Chronic pancreatitis
- Diabetes mellitus
- Prior abdominal radiation
- Family history
- Exposure to arsenic and cadmium (possibly gastric ulcer)
Pancreatic Cancer - Signs and Symptoms/Physical Exam Signs
- Courvoisier sign: Enlarged gallbladder which is nontender and accompanied by mild painless jaundice.
- In advanced cases, a hard periumbilical nodule (Sister Mary Joseph's nodule) may be palpable.
- Elevated CA 19-9 tumor marker can also be elevated with pancreatitis.
- Amylase and Lipase. Occult blood in the stool; combination of biliary obstruction and bleeding.
- Appearance: Stools may exhibit a distinctive silver appearance due to the combined effects of biliary obstruction and bleeding
Pancreatic Cancer - Imaging
- Transabdominal ultrasound
- Abdominal CT
- Endoscopic Ultrasound (EUS)
- Endoscopic Retrograde Cholangiopancreatography (ERCP)
- Magnetic Resonance Cholangiopancreatography (MRCP)
Pancreatic Cancer - Staging
- TNM classification (Tumor, Node, Metastasis) is used.
- Tis, T1, T2, T3, T4 represent increasing tumor size and extent.
- N1 and N2 represent regional lymph node metastasis.
- M1 signifies distant metastasis.
Pancreatic Cancer Treatment
- Surgical resection is ideal if possible, best achieved at multidisciplinary centers specializing in pancreatic cancer treatment.
- Endoscopic stenting of the bile duct can be used in cases where surgery is not feasible, to relieve jaundice.
- Chemotherapy generally hasn't shown much success in metastatic pancreatic cancer.
Pancreatic Cancer Prognosis
- Generally poor, especially with involvement of the body or tail of the pancreas.
- 5-year survival rate is 2-5% in advanced cases.
- Tumors in the ampulla area often have a better prognosis and 5-year survival rates of 20-40%.
- Jaundice and lymph node involvement are negative prognostic factors.
Colorectal Cancer
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Risk Factors: Personal or family history of adenomatous or serrated polyps or colorectal cancer.
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Symptoms/Signs (Proximal Colon): Fecal occult blood and anemia.
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Symptoms/Signs (Distal Colon): Bowel habit changes and hematochezia (bloody stools).
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Diagnosis: Colonoscopy.
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Characteristics: Colorectal cancer is the second leading cause of cancer death in the United States. Almost all cases are adenocarcinomas, tending to form bulky exophytic masses or annular constricting lesions.
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Polyps: Adenomatous polyps (tubular, tubulovillous, villous adenoma) and Serrated polyps (hyperplastic, traditional serrated adenoma and sessile serrated adenoma)
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Advanced Polyps: Advanced polyps include those ≥1 cm in size, with villous features or high-grade dysplasia, or serrated polyps with dysplasia that are associated with increased cancer risk.
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Risk Factors (cont.): Age, Family history, Inflammatory bowel disease, Race/ethnicity (Black/African American). Diet and lifestyle
Colorectal Cancer - Signs and Symptoms
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Obstruction, Constipation, Blood in stool, Abdominal pain.
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Laboratory Findings (metastatic concerns): Complete blood count (CBC) and anemia. Elevation of Alkaline Phosphatase (ALP) is suggestive of metastatic disease. Carcinoembryonic antigen (CEA) is sometimes checked but not useful for screening.
Colorectal Cancer - Imaging
- Colonoscopy (preferred diagnostic procedure for suspected colorectal cancer or abnormalities found in imaging). Barium studies were previously used but are less optimal now.
Colorectal Cancer - Staging
- TNM staging system used (Tumor, Node, Metastasis). TNM staging defines the location and extent of the cancer to inform treatment decisions.
Colorectal Cancer - Treatment
- Surgical resection is the primary treatment for resectable colorectal cancer.
- Systemic chemotherapy may improve survival in specific cases, depending on the stage of the cancer.
Colorectal Cancer - Screening
- People without a family history should begin screening at age 45, and continue as long as life expectancy is greater than 10 years.
- Colonoscopy is often the recommended choice every 10 years.
- Fecal Immunochemical Test (FIT) or CT Colonography are alternatives when colonoscopy is not a suitable option.
Referral/Admission
- Patients with cancer involving the pancreas and ampulla of Vater should be referred to specialists.
- Patients requiring surgery or other interventions should be hospitalized.
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Description
Test your knowledge on liver neoplasms with this quiz. Explore imaging modalities, types of benign tumors, and essential facts about liver cancer. Perfect for medical students and health professionals wanting to deepen their understanding of hepatic neoplasms.