Fibrolamellar carcinoma of the liver

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Q) Fibrolamellar Carcinoma of the liver  a) Occurs in the setting of cirrhosis b) Has worse survival than Hepatocellular carcinoma c) Can be followed up for long time d) Seen in young females Answer

Hydatid Cyst

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Q) All are true about hydatid cyst except? a) Liver is the commonest site followed by lung b) Most commonly presents as painless abdominal mass c) Anaphylaxis can occur if there is spillage during surgery d) Dog is the definitive host Answer for premium  

Hemangioma Liver

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Q) True about management of hemangioma liver a) All hemangioma more than 10 cm should be resected b) OCPs and pregnancy should be avoided in young females as there is risk of rupture c) Arterial embolization should be routinely done in large hemangiomas d) If surgery is decided  hemangioma located at the periphery should be enucleated Ans)d Whatever the size there is no role of resection for asymptomatic hemangioma. Risk of rupture is very small and therefore there is no rationale for stopping OCPS, pregnancy or physical activities.  Arterial embolization, which may be considered for temporary control of hemorrhage has limited success and is occasionally associated with morbidity In symptomatic hemangioma liver resection is the treatment of choice, in peripheral tumors enucleation and in centrally placed tumors, formal resection should be done REf Blumgart Surgery of liver 6th edition  

HCC Cancer

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Q) Which of the following is true about screening in hepatocellular carcinoma (HCC Cancer)  a) Alpha feto protein should be done 6 monthly b) Ultrasound abdomen should be done 6 monthly c) Candidates for liver transplant should be screened every 3 months d) Nodules more than 2 cm should be followed up  more regularly Answer b Cirrhosis is prone for development of HCC. Screeing has to be stringrnt.  Earlier ultrasound of liver and alpha feto protein were both used for screening In 2009 Marrero et al demonstrated the suboptimal accuracy of AFP and after that it has been removed from the screening protocol and now only ultrasound is being done. The screening recommendation is not for those patients with severe associated conditions and with advanced liver disease who are already considered for  transplant. So there is no screening for those who are already listed. Nodules more than 1 cm are highly suspicious where as in nodules less than 1 cm only 40% will be malignant. Ref: blumgart 6th edition