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Case 5

Image: slice of liver from a 60-year-old male showing two tumour deposits

This is a slice of liver from a 60-year-old male showing two tumour deposits. The background liver also had a greasy feel to its cut surface, suggestive of fatty change.

1
Question 1

Which of the following statements about liver neoplasms are true? (Tick all those that apply)

a)
b)
c)
d)

Correct. Most tumours in the liver are metastatic deposits. Production of bile implies hepatocellular carcinoma. Liver cell adenoma is a benign tumour composed of hepatocytes, seen mostly in young women. Liver cirrhosis is strongly associated with a risk of developing hepatocellular carcinoma; all patients known to have cirrhosis should have regular measurement of serum alpha-fetoprotein to screen for the development of this tumour.

Incorrect. Most tumours in the liver are metastatic deposits. Production of bile implies hepatocellular carcinoma. Liver cell adenoma is a benign tumour composed of hepatocytes, seen mostly in young women. Liver cirrhosis is strongly associated with a risk of developing hepatocellular carcinoma; all patients known to have cirrhosis should have regular measurement of serum alpha-fetoprotein to screen for the development of this tumour.

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2
Question 2

Which of the following statements about liver metastases are true? (Tick all those that apply)

a)
b)
c)
d)
Correct. Hepatic infiltration by metastases may cause abnormalities in liver function tests; however, extensive liver metastases may be present without any derangement at all. Jaundice only occurs with very advanced hepatic metastatic disease. Metastasis in the liver is not necessarily a contraindication to attempted curative treatment - they can be successfully excised in some patients. Gastrointestinal malignancies often give rise to liver metastases.Incorrect. Hepatic infiltration by metastases may cause abnormalities in liver function tests; however, extensive liver metastases may be present without any derangement at all. Jaundice only occurs with very advanced hepatic metastatic disease. Metastasis in the liver is not necessarily a contraindication to attempted curative treatment - they can be successfully excised in some patients. Gastrointestinal malignancies often give rise to liver metastases.Your answer has been saved.
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3
Question 3

Which of the following statements could explain the finding of the fatty change? (Tick all those that apply)

a)
b)
c)
d)

Correct. Fatty liver is a common, potentially reversible, change in the liver in which hepatocytes accumulate large amounts of lipid within their cytoplasm. Common causes of fatty liver include obesity, diabetes mellitus, and alcohol abuse. Anaemia has no direct association with fatty liver.

Page reference for whole case study: 195-6

Incorrect. Fatty liver is a common, potentially reversible, change in the liver in which hepatocytes accumulate large amounts of lipid within their cytoplasm. Common causes of fatty liver include obesity, diabetes mellitus, and alcohol abuse. Anaemia has no direct association with fatty liver.

Page reference for whole case study: 195-6

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