Malignant tumours of the liver

Malignant tumours of the liver are classified as primary or secondary (metastatic). Some of the tumours present with deranged liver functions tests and symptoms, but most remain asymptomatic with normal liver function tests.Common primary tumours of the liver are hepatocellular carcinomas and cholangiocarcinomas. The former are confined to the liver and usually originate in cirrhotic livers. Cholangiocarcinomas arise from the intra-or extrahepatic biliary tree. Secondary tumours of the liver account for 95% of hepatic malignancies, are manifestations of systemic spread of the primary, and usually indicate end-stage disease. Metastases from colorectal cancer and neuroendocrine tumours are two types of cancer in which liver resection is potentially curative.More liver tumours are being discovered incidentally due to improved imaging techniques; CT, MRI and PET offer earlier diagnosis and staging. Tumour markers and liver biopsy help in diagnosing selected cases.Treatment of liver tumours requires a multidisciplinary approach. This should be offered in tertiary referral centres equipped with a full range of diagnostic and therapeutic facilities. Surgery offers a potential cure for liver tumours. New chemotherapeutic agents and ablation techniques are promising and are being evaluated in the clinical setting. Recent medical advances have made treatment of malignant liver tumours safer and potentially curative.