Malignant liver tumours

The most common liver tumour is a secondary (Metastatic) tumour, particularly from the:

• GI tract
• Breast
• Bronchus

Types of malignant liver tumours:

There are 2 main types:

• Hepatocellular carcinoma (HCC)
• Cholangiocarcinoma:
• Intrahepatic
• Extrahepatic

Since HCC is the most common, it will be discussed here.

Aetiology:

• Carriers of HBV and HCV
• Aflatoxin
• Androgenic steroids
• Is an association with the OCP

Pathology:

• The tumour may be single or multiple
• Can metastasize via the hepatic or portal veins to:
• Lymph nodes
• Bones
• Lungs

Clinical features:

• Usually present before the age of 50 years
• Weight loss
• Anorexia
• Fever
• Ache in the right hypochondrium
• Ascites
• Enlarged, irregular, tender liver may be palpable

Investigations:

• Raised serum α-fetoprotein
• Liver biopsy (for diagnosis)

Treatment and prognosis:

• Surgical resection is occasionally possible
• Chemotherapy and radiotherapy are unhelpful
• Survival is less than 6 months