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 B vaccination against hepatitis B Alcohol consumption is to be avoided Food

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