Liver Cancer Basic Function The liver is a
Liver Cancer
Basic Function: � The liver is a vital organ � Wide range of functions, including detoxification, glycogen storage, protein synthesis, and production of biochemicals necessary for digestion, decomposition of red blood cells � It produces bile, an alkaline compound which aids in digestion via the emulsification of lipids
Anatomy � Liver is both the largest internal organ and the largest gland in the human body � Connected to two large blood vessels (hepatic artery and portal vein) � Hepatic artery carries blood from the aorta � Portal vein carries blood containing digested nutrients from the entire gastrointestinal tract and also from the spleen and pancreas
Anatomy � The falciform ligament divides the liver into a left anatomical lobe, and a right anatomical lobe � Cantlie's Line: an imaginary line that passes to the left of the vena cava all the way forward and sections the gallblader into two halfs � The central area where the CBD, PV, and hepatic artery proper enter is the hilum or "porta hepatis”
Couinaud segment
Hepatocellular carcinoma � HCC is the most common type of liver cancer � Most cases of HCC are secondary to either a viral hepatitis infection (hepatitis B or C) or cirrhosis (alcoholism being the most common cause of hepatic cirrhosis) � Abdominal pain, especially in the right upper quadrant, N/V, or fatigue, loss of appetite, weight loss, � Ascites, easy bruising from blood clotting abnormalities and jaundice
Liver cancer
Risk factors � Alcoholism � Hepatitis B � Hepatitis C � Aflatoxin � Cirrhosis � Hemochromatosis � Type 2 Diabetes (probably aided by obesity)
Diagnosis � LFT � Alfa-fetoprotein � U/S � CT � MRI
Staging � size � involvement of liver vessels � presence of a tumor capsule � presence of extrahepatic metastases � presence of daughter nodules � vascularity of the tumor (MRI is the best imaging method to detect the presence of a tumor capsule)
Treatment � Liver transplantation � Surgical resection � Percutaneous ethanol injection (PEI) � Transcatheter arterial chemoembolization (TACE) � Radiofrequency ablation (RFA) � Radiation � Chemotherapy ( esp. receptor tyrosine kinase inhibitor, Sorafenib)
Prevention � Hepatitis � Alcohol � Food B vaccination against hepatitis B consumption is to be avoided
Thank you
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