Chapter 23 - Liver tumours

Abstract

Publisher Summary This chapter discusses the clinical features, diagnosis, and treatment of various liver tumors such as hepatoblastoma, hepatocellular carcinoma, rhabdomyosarcoma, mesenchymal sarcoma, primary malignant germ cell tumors, mesenchymal hamartoma, and focal nodular hyperplasia. Hepatoblastomas are single large tumors that arise in and distort an otherwise normal liver. The majority occur in the right lobe. Characteristically they are supplied by large vessels and have many dilated sinusoidal channels. Hepatocellular carcinoma is less common than hepatoblastoma except in areas in which there is a high prevalence of hepatitis B virus infection in childhood. Hepatocellular carcinoma frequently starts in a liver with underlying cirrhosis. The tumor is often multicentric. Rhabdomyosarcoma is a rare tumor and usually arises from the common bile duct, but can occur in the common hepatic duct or even within the liver. The bile duct wall becomes thickened by a polypoid tumor, which grows along it and encroaches on the lumen with grape-like extensions. Mesenchymal sarcomas are rare tumors consisting of sarcomatous cells with frequent mitosis and areas of necrosis that produce space-occupying hypovascular lesions usually in the right lobe of the liver. Benign tumors usually present with hepatomegaly, abdominal distension or abdominal discomfort. Rarely they may be the sites of infection or bleeding into the peritoneum.