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Liver cancer Hepatocellular carcinoma PowerPoint Presentation

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Slide 1 - Hepatocellular carcinoma Diagnosis, Treatment, Prognosis + Quiz Vinko Bubic Mentor: A. Žmegač Horvat
Slide 2 - Diagnosis Physical examination - enlarged, tender liver Elevated serum alpha fetoprotein (normally : 40mg/l) Elevated liver enzymes (ALT, AST, Alpha-1 antitrypsin, serum bilirubin, urine bilirubin...)
Slide 3 - Diagnosis CT
Slide 4 - CT Computed tomography - medical imaging method employing tomography (imaging by sections or sectioning) Large series of two-dimensional X-ray images taken around a single axis of rotation, computer integration Iodine dye through vein for better visualisation (allergy)
Slide 5 - ppt slide no 5 content not found
Slide 6 - MRI Magnetic resonance imaging The body - mainly composed of water molecules Electromagnetic field causes protons to absorb some of its energy Scanner detects release of proton energy (tumor tissue releases different frequency) Greater contrast than CT
Slide 7 - Modern 3T MRI
Slide 8 - Biopsy Definitive diagnosis of hepatocellular carcinoma
Slide 9 - Hyperchromatic, clear cells with large red cytoplasm
Slide 10 - Treatment Liver transplatation (cadaver liver or live donor lobe) Surgical resection (best prognosis for long-term survival, but possible in only 10-15% of cases)
Slide 11 - Treatment Percutaneus ethanol injection - small (< 3 cm) solitary tumors Transcatheter arterial chemoembolization (TACE) - more than 3 cm and less than 4 cm in diameter Sealed source radiotherapy (brachytherapy) - radioactive source is placed inside or next to area requiring treatment
Slide 12 - Prior to ethanol ablation After
Slide 13 - Transcatheter arterial chemoembolization
Slide 14 - Other techniques Radiofrequency ablation (RFA) High intensity focused ultrasound (HIFU) Chemotherapy (antiestrogen + tamoxifen) Cryosurgery - destruction of abnormal tissue using sub-zero temperatures
Slide 15 - HIFU
Slide 16 - Cryosurgery Iceball
Slide 17 - HCC complications Gastrointestinal bleeding Cachexy Portal hypertension -> esophageal bleeding Liver failure Metastasis (lymph nodes around pancreas, aorta, lungs, adrenal glands, bones) Rupture of tumor -> abdominal bleeding
Slide 18 - Prognosis Usually poor outcome Only 10 - 20% of hepatocellular carcinomas can be removed completely If not, disease usually deadly within 3 to 6 months
Slide 19 - Quiz: The definitive HCC diagnosis is confirmed by: a) spider nevus by inspection b) auscultation c) biopsy and microscopy d) MRI e) esophageal reflux
Slide 20 - Ethanol: a) dehydrates cells b) hydrates cells and cracks them c) activates IL-8 d) causes apoptosis e) nothing from above
Slide 21 - In cryotherapy, tumor is frozen by: a) flucloxacillin b) Iodine c) liquid nitrogen d) surgeon’s eye e) cocaine
Slide 22 - What did you eat today? This maybe? 
Slide 23 - Thanks ! ! !
Slide 24 - References: http://www.cancer.gov/cancertopics/types/liver/ http://www.mayoclinic.com/health/liver-cancer/DS00399 Medicinski leksikon, Leksikografski zavod “Miroslav Krleža”, Zagreb 1992. PATOLOGIJA, urednici Damjanov, Jukic, Nola, izdanje 2007.