Most common liver cancer

- the most common liver cancer is metastatic disease.

- it outnumbers primary tumors 20:1.

- primary site is usually the GI tract.

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Most common primary benign liver tumor

- Hemangioma

Other benign liver masses

- benign liver cyst

- bile duct hamartomas

- bile duct adenoma

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workup for liver metastasis

- LFTs (AST and alkaline phosphatase are most useful)

- CEA for suspected primary colon cancer

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Three common types of primary benign liver tumors

1. hemangioma

2. hepatocellular adenoma

3. foacl nodular hyperplasia

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Four common types of primary malignant liver tumors?

1. hepatocellular carcinoma (hepatoma)

2. cholangiocarcinoma (when intrahepatic)

3. angiosarcoma (associated with vinyl chloride, arsenic, or thorotrast contrast exposure)

4. hepatoblastoma (most common in infants and children)

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hamartoma

- white hard nodule made up of normal liver cells in a nodular arrangement

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Differential diagnosis of liver mass

A. Benign

1. Neoplastic

- cavernous hemangioma

- focal nodular hyperplasia

- adenoma

- hamartomas - normal tissue arranged in a disorderly fashion

2. Non-neoplastic

- simple cysts

- polycystic liver disease - other organ involvement

- choledochal cyst - Types IV and V

- echinococcal cyst

B. Malignant

1. Primary

- hepatocellular carcinoma (HCC) - 90% of primary malignant lesions

- cholangiocarcinoma - 7% of primary malignant lesions

- hepatoblastoma

- sarcoma - angiosarcoma, leiomyosarcoma, others

- epithelioid hemangioendothelioma

2. Metastatic

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