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February 26, 2026
TUMORS OF THE LIVER — SHORT SUMMARY NOTES
BENIGN TUMORS
Cavernous Hemangioma Most common benign liver tumor ⭐
Incidental finding
DO NOT biopsy (hemorrhage risk)
Focal Nodular Hyperplasia (FNH)
## Detailed Notes
Central stellate scar ⭐
No OCP link, no malignant potential, no rupture
Liver Cell Adenoma
Young women + OCPs ⭐
Can rupture → intraabdominal hemorrhage ⭐
Can be mistaken for HCC
Regresses on stopping OCPs
MALIGNANT — PRIMARY
Hepatocellular Carcinoma (HCC)
M:F = 3:1 to 8:1
Risk factors: HBV (200x risk), HCV, alcohol, aflatoxin B1, cirrhosis
Vascular invasion ⭐
AFP > 1000 ng/ml highly suggestive ⭐
Fibrolamellar variant = better prognosis ⭐
Px: death 6 months-1 year
Rx: surgical resection
Cholangiocarcinoma
Bile duct origin
NOT associated with HBV/HCV ⭐
Risk factors: PSC, Opisthorchis sinensis, Thorotrast
AFP normal
Angiosarcoma
Vinyl chloride + arsenic + Thorotrast ⭐
Hepatoblastoma
Children ⭐
MALIGNANT — SECONDARY (METASTATIC)
Most common hepatic malignancy overall ⭐
Sources: colon > lung > breast ⭐
Key comparison:
| | HCC | Cholangiocarcinoma |
|---|---|---|
| HBV/HCV | Yes | No |
| AFP | ↑↑ | Normal |
| Risk | Cirrhosis, aflatoxin | PSC, Opisthorchis |
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