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Liver metastases

Definition

Liver metastases are cancerous tumors that have spread to the liver from somewhere else in the body.

See also: Hepatocellular carcinoma

Alternative Names

Metastases to the liver; Metastatic liver cancer; Liver cancer - metastatic

Causes, incidence, and risk factors

Cancers that may spread to the liver include:

• Breast cancer
• Colorectal cancer
• Esophageal cancer
• Lung cancer
• Melanoma
• Pancreatic cancer
• Stomach cancer
• Adrenal cancer

The risk of cancer spreading to the liver depends on the site of the original cancer. A liver metastasis may be present when the original (primary) cancer is diagnosed, or it may occur months or years after the primary tumor is removed.

Symptoms

In some cases, there are no symptoms. When symptoms occur, they may include:

• Anorexia
• Confusion
• Fevers
• Jaundice (yellowing of the skin and whites of the eyes)
• Nausea
• Pain, usually in the upper right part of the abdomen
• Sweats
• Weight loss

Signs and tests

Tests that may be done to diagnose liver metastases include:

• CT scan of the abdomen
• Liver function tests
• MRI of the abdomen
• PET scan
• Ultrasound of the liver

Treatment

Treatment depends on:

• The primary cancer site
• How many liver tumors you have
• Whether it has spread to other organs besides the liver
• Your overall health

When the cancer has spread to the liver and other organs, whole-body (systemic) chemotherapy is usually used.

When the spread is limited to the liver, systemic chemotherapy may still be used. However, other treatment methods may be effective. When the tumor is only in one or a few areas of the liver, the cancer may be removed with surgery.

The use of radiofrequency waves or injection of toxic substances may also be used to kill tumors. When larger areas of the liver are involved, treatment may involve giving chemotherapy directly into the liver, or a procedure called embolization, which blocks blood flow to parts of the liver to "starve" the tumor cells.

Support Groups

Expectations (prognosis)

How well you do depends on the location of the original cancer and how much it has spread to the liver. In a small number of cases, surgery to remove the liver tumors may lead to a cure. This is usually only possible in patients with certain tumor types (for example, colorectal cancer), and when there are a limited number of tumors in the liver.

In most cases, cancer that has spread to the liver is not curable. Patients with liver metastases usually die of their disease eventually. However, treatments may help shrink tumors, improve life expectancy, and relieve symptoms.

Complications

Complications are generally the result of tumors spreading to a large area of the liver.

They can include:

• Blockage of the flow of bile
• Decreased appetite
• Fever
• Liver failure (usually only in the late stages of disease)
• Pain
• Weight loss

Calling your health care provider

Call your health care provider if you have cancer and suspect that it has spread to the liver. Anyone who has had a type of cancer that can spread to the liver should be aware of the signs and symptoms listed above, and call a physician if any of these develop.

Prevention

Early detection of some types of cancer may prevent the spread of these cancers to the liver.

References

Lewis RL. Liver and biliary tract tumors. In Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 206.