TUMORS OF THE LIVER

[liveonearth]

HEPATIC HEMANGIOMA
--benign
--most common liver tumor, found in 7-8% of autopsy specimens

HEPATOCELLULAR CARCINOMA
--most frequent primary liver cancer: malignant
--aka hepatoma
--strong assocation with hep B infx
--most common visceral tumor
--often arises in setting of cirrhosis
--infants who contract HBV at birth have 200 fold risk of this CA
--in the US chronic alcoholism is most common cause of this CA
--greenish yellow hue
--elevated serum alpha-fetoprotein -- follow!
--mass may obstruct biliary tract-->elevated ALP
--markers: CA 19-9 and CA-50 are usu positive in cases of cholangiocarcinoma while often negative in cases f hepatocellular carcinoma

METS
--most tumors in liver are mets
--most often from GI, colon
--also from breast, ovary, renal, prostate

HEPATIC ADENOMA
--NOT hepatoma
--benign glandular tumor
--in young women on oral contraceptives
--resolve on discontinuation of pill (if not too gross already)
--may rupture and cause introperitoneal hemorrhage
--well circumscribed
--disorganized tissue

CHOLANGIOCARCINOMA
--second most common primary liver cancer
--from bile duct epithelium
--relatively rare, fewer than 10% of all liver primary malignancies
--risk factors: chronic inflam/injury of biliary epithelium
--markers: CA 19-9 and CA-50 are usu positive in cases of cholangiocarcinoma while often negative in cases f hepatocellular carcinoma

HEPATIC ANGIOSARCOMA
--endothelial tumor that may occur in skin and soft tissue and breast and heart
--rare but notably associated with ARSENIC and high levels of polyvinyle chloride in plastics industry