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The liver is the largest solid human organ and is located in the upper abdomen, under the ribs, on the right side of the body. It is responsible for using substances absorbed by the intestine and producing proteins that perform various functions in the body, such as: blood clotting and defense against infections. One of its products is bile (stored in the gallbladder and eliminated in the first portion of the small intestine, called the duodenum, through the duct that connects these two structures).
Types of Liver Tumors
Liver tumors, also called hepatic tumors, are divided into benign and malignant, according to their clinical behavior:
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Benign tumors: are not capable of spreading to other regions. Among them, the following stand out: hemangiomas, Focal Nodular Hyperplasia (FNH), osadenomas and cysts.
Malignant tumors: can send metastases to the liver itself, lymph nodes, bones and other organs. They are divided into primary and metastatic.
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Primary tumors: arise from cells in the liver itself (hepatocarcinoma) or from the bile channels that exist inside the organ (cholangiocarcinomas). Angiosarcomas and hepatoblastomas are rare types of liver tumors. Hepatocellular carcinoma arises from liver cells called hepatocytes. Its incidence worldwide is very high, with around 500,000 new cases diagnosed each year.
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metastatic tumors: more frequent, as the liver is a common site for metastases of various types of cancer from practically all organs of the human body. The most common are: bowel cancer (colon and rectum) and neuroendocrine tumors, the treatment of which is surgical whenever possible. Recently, selected cases of liver metastases from other organs, such as sarcomas, kidney tumors, breast tumors, melanoma, duodenal papilla, gynecological tumors, and even gastric cancer have been considered for surgical treatment.
Diagnosis
The diagnosis of gastric cancer is carried out by combining imaging tests (ultrasound, computed tomography or nuclear magnetic resonance) and laboratory tests (measurement of Alphafeto-protein – a substance produced by most of these tumors). Occasionally, a biopsy of suspicious lesions may be necessary.
PET-CT is useful in staging and therapeutic decisions in some cases.
Symptoms
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The main symptoms include: weight loss, increased abdominal volume (accumulation of fluid inside the abdomen – ascites) and jaundice (yellowing of the eyes and skin due to the accumulation of bilirubin in the body).
Treatment
The treatment of Hepatocellular carcinoma depends on the staging of the tumor (extent of the lesion in the liver and the presence or absence of metastases) and the patient's clinical conditions, especially liver function.
As in many cases there is associated cirrhosis, treatment must take this factor into account. Therefore, it is essential that this treatment is carried out in a multidisciplinary environment from the beginning, where it is discussed jointly between the Oncological Surgeon, the Clinical Oncologist, the Interventional Radiologist, Radiotherapist, Liver Transplant Team, Nutritionists and Nurses.
The main risk factors for this disease are: liver cirrhosis, caused by viral infections such as Hepatitis B and C and alcohol abuse; autoimmune hepatitis; hepatitis related to the accumulation of fat in the liver (hepatic steatosis), related to obesity; hypothyroidism and metabolic syndrome.
