Liver Cancer
The largest organ in the body, the liver is often the site of metastatic cancer, especially from carcinomas that arise in abdominal viscera. Primary cancers of the liver are uncommon in the United States, although common in many other countries. Several distinctive malignant tumors are found in the liver. These include hepatocellular carcinomas that originate from hepatocytes, cholangiocarcinomas or intrahepatic bile duct carcinomas that arise from bile ducts, and sarcomas that arise from mesenchymal elements. Hepatocellular carcinomas are often associated with pre-existing liver disease, usually cirrhosis, which may dominate the clinical picture. The liver has a dual blood supply: the hepatic artery, which branches from the celiac artery and the portal vein, which drains the intestine. Blood from the liver passes through the hepatic vein and enters the inferior vena cava. Hepatocellular carcinomas have a proclivity to invade blood vessels. Invasion of adjacent structures such as the diaphragm, adrenal gland, inferior vena cava, or hilar vessels often makes resection of the tumor difficult or impossible. The most important indicators of outcome are resectability for cure and extent of disease.
