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The most common tumors in the liver are metastases. Metastasis is the medical term for the spread of a cancer belonging to another organ or tissue to the liver. Cancers from almost anywhere in the body can spread to the liver. In liver metastases, they appear as masses of different sizes within the liver. Metastases may be single or multiple and of various sizes. Colorectal (large bowel) cancers in particular tend to metastasize to the liver. The metastases of this type of cancer are the group that benefits most from liver resection, and after complete removal of the metastases in the liver, together with chemotherapy, patients may have a chance of being free of the disease.
Liver cancer refers to malignant tumors arising from the liver's own tissue. The most common among them is hepatocellular carcinoma (HCC) and it makes up the great majority of cases. It is the fifth most common of all cancers and plays an important role in cancer deaths.
The remaining cases are mostly tumors called intrahepatic (within the liver) cholangiocarcinoma that originate from the bile ducts.
Although the cause of liver cancer is not known with certainty, in 90% of patients it develops on the basis of chronic liver disease. Hepatitis B and hepatitis C viruses, alcohol-related liver cirrhosis, NASH (non-alcoholic steatohepatitis, chronic liver disease due to fatty liver), liver adenoma, carcinogenic substances found in foods (aflatoxin, etc.), certain drugs, and metabolic diseases such as hemochromatosis are known to increase the risk.
Although many patients with liver cancer have no complaints, a doctor should be consulted for complaints such as swelling in the abdomen, pain in the right part of the abdomen, and yellowing of the skin.
Liver cancer appears as a space-occupying tumor in the liver on various radiological methods (ultrasonography, MR imaging, computed tomography).
Tumor markers (AFP; alpha-fetoprotein for HCC and CA19-9 for cholangiocarcinoma) provide valuable information about the biology of the tumor.
In liver cancer, the treatment from which patients benefit most is surgical treatment. Here, the treatment options are resection of part of the liver so as to include the tumor (or tumors), or liver transplantation.
In tumors for which surgery is not suitable, or in patients thought unable to tolerate surgery, chemotherapy, radiotherapy, transarterial chemoembolization (TACE) or radiofrequency ablation (RFA) by interventional radiology, and nuclear medicine treatments (TARE) can be applied.
BENIGN TUMORS OF THE LIVER
In addition to cancers, benign tumors can also occur in the liver. The most common benign tumors of the liver are hemangioma, adenoma and focal nodular hyperplasia.
Hemangiomas are the most common benign tumors of the liver. They carry no risk of becoming cancerous, and their risk of bleeding by rupturing is also low. For this reason, patients are generally followed with serial imaging studies. However, these tumors can sometimes cause abdominal pain that seriously disturbs the patient, or grow within the liver to a dangerous size; surgical treatment should be considered in these patients.
Adenomas, on the other hand, are tumors that carry a risk of becoming cancerous and a risk of bleeding by rupturing. In most patients, removal of part of the liver so as to include the tumor (liver resection) is necessary.
Focal nodular hyperplasia (FNH) has no risk of becoming cancerous. However, tumors in patients with abdominal pain complaints, or tumors whose diagnosis cannot be distinguished from cancer before surgery, should be removed.
