The Role of the Pathologist in the Clinical Management of Malignant Liver Tumors

Abstract

A multiplicity of different tumours can arise in the liver, each with its own distinctive pathology but many of these are rarities and useful information about them is scant. In tropical Africa and Southeast Asia, liver cell (hepatocellular) carcinoma is one of the commonest of all malignancies but this tumour is rare in Western countries and is seldom amenable to surgery. Bile duct carcinoma (cholangiocarcinoma) is next in importance. It occurs more or less equally throughout the world except in Southeast Asia, where a high incidence is seen in those infested with liver flukes. All other primary tumours are rare though some, like liver cell adenoma, hemangiosarcoma and tumours occurring in children, are of considerable interest. In Western countries, secondary tumours, particularly those from primary carcinomas of the gastrointestinal tract, breast and lung, are by far the commonest and their presence is no longer regarded as hopeless for the patient.