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Liver Metastases : Introduction

 
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Introduction: Liver is one of the most frequent sites for metastatic spread of tumors. Autopsy studies have shown that liver metastases occur in 40% to 50% of adults dying of cancer. Metastases are far more common than primary hepatic malignancies in non-cirrhotic livers in Western countries.

Pathogenesis: Liver is a particularly receptive organ to metastases from many sites due to its dual blood supply (hepatic and portal). The sinusoidal epithelium has fenestrations which allow malignant cells to escape circulation and enter liver parenchyma. Liver is often the sole site of metastatic disease.

The predominant histologic subtypes are adenocarcinomas, squamous cell carcinomas, and neuroendocrine carcinomas. Primary Sites: ADULTS: The most common metastatic tumors in the liver are derived from primary cancers of the gastrointestinal tract and pancreas which drain into the liver via portal circulation. In addition, malignancies of lung, breast, kidney, malignant melanomas, lymphomas and soft tissue sarcomas also frequently metastasize to liver. Primary malignancies of gall bladder, extrahepatic bile ducts, stomach, and pancreas can involve liver by direct extension. CHILDREN: The most common primary sites in children are neuroblastoma, Wilms tumor, and rhabdomyosarcoma.

This photograph shows liver metastases from small cell carcinoma of lung.

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