A liver metastasis is a malignant tumor in the liver that has spread from another organ that is affected by cancer. This can also be called secondary liver cancer or metastatic liver disease. The liver is a common site for metastatic disease because of its rich, dual blood supply (the liver receives blood via the hepatic artery and portal vein). Metastatic tumors in the liver are 20 times more common than primary liver tumors (tumors that originate in the liver). In 50% of all cases the primary tumor is of the gastrointestinal tract; other common sites include the breast, ovaries, bronchus and kidney. People with colorectal cancer are at risk of liver metastases.[1]
The signs and symptoms of secondary liver cancer are usually fairly non-specific (they can also be caused by other things). The following is a list of possible signs and symptoms of liver metastasis:[2]
Tumor emboli entering the sinusoids through the liver blood supply appear to be physically obstructed by the Kupffer cells, but if tumor emboli are larger, they tend to become lodged in the portal venous branches.[citation needed]
Diagnosis
Imaging such as triple-phase CT scans or MRI's are required to evaluate and diagnose a suspected metastasis on the liver.[5] The imaging may also provide information about the source of the primary disease.[3] Other diagnostic criteria include:[medical citation needed]
Cross section of a human liver, taken at autopsy examination, showing multiple large pale tumor deposits. The tumor is an adenocarcinoma derived from a primary lesion in the body of the pancreas.
Main sites of metastases for some common cancer types, showing liver as the target for many types. Primary cancers are denoted by "...cancer" and their main metastasis sites are denoted by "...metastases".[6]
In some tumors, notably those arising from the colon and rectum, apparently solitary metastases or metastases to one or other lobes may be resected. A careful search for other metastases is required, including local recurrence of the original primary tumor (e.g., via colonoscopy) and dissemination elsewhere (e.g., via CT of the thorax). 5-year survival rates of 30-40% have been reported following resection. [citation needed]
When resection for cure is not possible (R0 resection), percutaneous ethanol injection has been suggested to dehydrate and kill the tumour cells, however there is not enough evidence to determine the effectiveness and safety of this approach.[7]
Over 5% of people with primary cancer developed liver metastasis.[4] In 70% to 80% of metastatic colorectal cancer cases, the spread is limited to the liver.[3] The overall survival at 1-year has been estimated to be about 15%.[4] Overall, survival may be lower in people with primary cancer in the testis, breast, prostate, anus, and people with melanoma.[4]
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