Everyone in our day to day life must have definitely heard about the death of person due to liver failure, liver cirrhosis or liver cancer. We must have also presumed that death of the person is because of excessive consumption of alcohol. This is not only the primary reason, but is just one of the risk factor causing the death; there are other factors that can also cause liver problems.
Liver is very important organ found only in vertebrates which carries out multiple functions like detoxification, production of biochemicals which helps in digestion, metabolism and regulation of glycogen storage, production of hormones and decomposition of RBC’s.
Liver tumors or hepatic tumors are tumors or growth on or in the liver. As it is made up of many types of cells and carries out multiple functions, several distinct types of tumors can develop in the liver. Liver is usually accessible to cancer cells travelling in the bloodstream, since all the blood in the body must pass through it. It can be affected by primary liver cancer, which arises in the liver or by cancer which are formed in other parts of the body and then spreads to the liver. Most liver cancers are metastatic, which means it originated elsewhere in the body. Primary liver cancer accounts for only 2% in US, but up to half of all cancers in some underdeveloped countries. This is due to prevalence of hepatitis, caused by contagious virus, which predisposes a person to liver cancer.
The more common benign tumors of liver include:
- Focal nodular hyperplasia
- Hepatic adenoma
None of the above tumors are treated like liver cancer. They need to be removed surgically, if they cause pain or bleeding.
Liver or hepatic cancers include:
- Eptheloid haemangioendothelioma
- Hepatic angiosarcoma
- Hepatocellular carcinoma (HCC)
- Primary lymphoma
Signs and symptoms of benign tumors
- Bleeding, thrombocytopenia and coagulopathy
- Fever with abdominal pain
- Hemangiomas are rarely symptomatic, except in cases involving large tumors. Complications consist of acute hemorrhagic shock.
- In some cases, jaundice has been observed
Clinical symptoms and patient history are crucial in determining the extent of diagnostic workup. The challenge is to determine between the lesions which must be removed, tumors that should be monitored and tumors that may be ignored. An ultrasound or computed tomography or MRI can help in identifying the type of tumor. The doctor might ask the history about malignancy in family, past history of blood transfusion, hepatitis, intravenous drug use and estrogen or progesterone use. In some cases, liver biochemistry, viral serology and tumor makers are useful for detecting liver disease.
In case of bleeding tumors, arterial embolization is the initial treatment of choice. In case of misdiagnosis, a laparotomy can be performed. For cystic tumors, laparoscopic fenestration or deroofing of the cyst is the best method. For asymptomatic adenomas like Focal Nodular Hyperplasia (FNH) and hemangiomas, surgery must be discussed in terms of preventive strategy, because of risk of bleeding and malignancy.
The development of laparoscopic surgery all over the world has changed the treatment approach towards benign tumors. Currently, laparoscopic liver resection is feasible and safe when performed by experienced surgeons. Laparoscopy is the best standard for the management of hepatic cysts, small benign tumors and multiple benign lesions. The most beneficial aspect of laparoscopy is a reduction of the invasiveness of liver resection in terms of postoperative pain and cosmetic outcome. Benign tumors constitute a rare indication for liver transplantation.
The goal of surgery depends on the symptoms and on nature of various tumors. The clinical challenge is to perform safe surgery to justify preventive surgery and to decrease the rate of diagnostic surgery.
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Radha K. Iyer is a contributing writer on Treatum Blog. When she is not writing, she can be found reading health and food blogs or experimenting with her culinary skills.
Disclaimer: The entire content of this article is for information purpose only and is not intended to replace a one-on-one relationship with a qualified health care professional. It is intended as a sharing of knowledge and information. It is not a substitute for professional care and should not be used for diagnosing or treating a health problem and disease.