Color ultrasound examination on the liver has a tumor, what way to solve.

Liver tumors can be non-cancerous (benign) or cancerous (malignant). Cancerous tumors can originate in the liver or spread (metastasize) from other parts of the body to the liver. Cancers originating in the liver are called primary liver cancer, while cancers originating in other parts of the body are called metastatic cancer. The vast majority of liver cancers are metastatic.

Benign liver tumors are fairly common but usually cause no symptoms. The vast majority of these tumors are found by ultrasound, CT, or MRI scans of patients for other reasons. However, some benign tumors can also cause liver growth or intraperitoneal bleeding. Liver function generally appears normal, so blood tests show normal or only mild abnormalities in liver enzymology.

- Hepatocellular adenoma

Hepatocellular adenoma is a common benign tumor of the liver.

Oral contraceptives may increase the risk of hepatocellular adenomas occurring mainly in women during their reproductive years. Most of these tumors go undetected because they are usually asymptomatic. Rarely, adenomas can rupture, causing intraperitoneal bleeding and requiring emergency surgical treatment. Adenomas caused by oral contraceptives often disappear when women stop taking them, and in rare cases, adenomas can turn into cancer.

- Hepatic hemangioma

Hepatic hemangioma is a tumor formed by abnormal blood vessels in the liver.

It is estimated that 1% to 5% of adults have asymptomatic hepatic hemangiomas. These tumors are usually found when a patient has an ultrasound or CT scan and do not require treatment. In children, large hepatic hemangiomas have occasionally been found to cause symptoms such as extensive thrombosis and heart failure. Surgery is needed.

- Hepatocellular tumor

Hepatocellular carcinoma (HCC) is a cancer that originates in the liver cells.

Hepatocellular carcinoma is the most common primary liver cancer (primary liver cancer), more common than metastatic liver cancer and the leading cause of death in some parts of Africa and Southeast Asia. These regions have a high prevalence of chronic infection with the hepatitis B virus, which increases the risk of hepatocellular carcinoma by 100 times. Chronic infection with the hepatitis C virus also increases the risk of hepatocellular carcinoma, and finally, certain cancer-causing substances (carcinogens) can cause hepatocellular carcinoma. Hepatocellular carcinoma is common in subtropical regions, and food is often contaminated with carcinogens called aflatoxin, which is produced by certain fungi.

In North America, Europe and other parts of the world, hepatocellular carcinoma is rare and the vast majority of patients with HCC are alcoholics with long-term cirrhosis. Hepatocellular carcinoma may be associated with other types of cirrhosis. Primary biliary cirrhosis is less dangerous than other types of cirrhosis.

Fibrolamellar carcinoma is a rare type of hepatocellular carcinoma that usually occurs in fairly young adults and is not associated with cirrhosis, hepatitis B or C, or other known risk factors.

The symptoms

The first symptoms of hepatocellular carcinoma are usually abdominal pain, emaciation, and a large mass in the right upper abdomen. In addition, the symptoms of patients with long-term cirrhosis are gradually aggravated, which is also one of the clinical manifestations of liver cancer. Fever is common. The first symptoms are occasionally acute abdominal pain and shock, the latter caused by rupture or bleeding of the cancer.

. Diagnosis

Patients with hepatocellular carcinoma have high levels of alpha-fetoprotein in their blood. Blood tests occasionally show hypoglycemia, hypercalcium, hyperfat, and hypererythrocytopaemia.

First, symptoms don't provide many diagnostic clues, and doctors can suspect liver cancer if the liver is large enough to be touched anyway, especially if the patient has a long history of cirrhosis. Sometimes, the doctor can hear percussion sounds (liver murmurs) and snow rolling sounds (fricatives) with a stethoscope on the surface of the liver.

Abdominal ultrasound and CT scans can sometimes reveal asymptomatic liver cancer. In some countries where hepatitis B is common, such as Japan, ultrasound scans are used to screen people infected with hepatitis B for liver cancer. Hepatocellular carcinoma can be detected by hepatic angiography (photography with contrast agent injected into the hepatic artery). Hepatic arteriography is especially valuable before surgery. Because it can show the exact position of liver blood vessels, so it is very helpful for surgery.

A liver biopsy, in which a small piece of liver tissue is extracted with a needle for microscopic examination, can confirm the diagnosis. The risk of bleeding and other damage in liver biopsies is low.

Prognosis and treatment

Patients with hepatocellular carcinoma often have a poor prognosis because it is detected too late. Occasionally, patients with small liver cancer can survive for a long time after tumor resection.

- Other primary liver cancers

Hepatocellular carcinoma (HCC) is a cancer of the lining epithelium of the bile duct or common bile duct. Liver fluke infection may be associated with cholangiocarcinoma in eastern countries. Patients with long-term ulcerative colitis and sclerosing cholangitis occasionally develop secondary bile duct cell carcinoma.

Hepatoblastoma is a common cancer of infants and young children, but occasionally occurs in older children. Tumors produce a hormone called gonadotropin, which can lead to early puberty in children. Hepatoblastoma is usually found with deterioration of health or palpation of a large mass in the right upper abdomen.

Angiosarcoma is a rare primary cancer of liver blood vessels. Factory exposure to vinyl chloride can cause angiosarcoma.

Diagnosis and treatment

Cholangiocarcinoma, hepatoblastoma and angiosarcoma can only be diagnosed by liver biopsy, in which a small piece of liver tissue is drawn with a needle for microscopic examination. Treatment is usually of little value, and the vast majority of patients die within months of diagnosis. If the tumor is found early, the tumor can be removed and the patient has the hope of long-term survival.

- Metastatic liver cancer

Metastatic liver cancer is a tumor that spreads to the liver from other parts of the body.

Metastatic liver cancer is most commonly found in the lungs, breast, colon, pancreas, and stomach. Leukemia and other blood cell cancers such as lymphosarcoma can involve the liver, and sometimes metastatic liver cancer is found before the primary cancer.

The symptoms

Usually, the first symptoms are emaciation and loss of appetite. In typical patients, the liver may become enlarged, hardened, tender, and febrile, and occasionally the spleen may enlarge, especially if the cancer is originally from the pancreas. Abdominal fluid leakage accumulation, ascites. Initially, jaundice is absent or mild, unless the cancer obstructs the bile duct. The jaundice gradually increases in the weeks leading up to death. When toxic substances accumulate in the brain, the patient may also appear delirium, lethargy, this condition is called hepatic encephalopathy.

. Diagnosis

Metastatic liver cancer is usually easily diagnosed in the advanced stages of the disease, but early diagnosis is difficult. Ultrasound, CT, and MRI liver examinations can reveal cancer, but these examinations do not always detect small tumors or distinguish tumors in cirrhosis and other abnormalities. Tumors usually cause abnormal liver function, which can be detected by blood tests.

Liver biopsy, in which a small piece of liver tissue is drawn from a needle for examination, is only definitive in about 75% of patients. To improve access to cancer tissue, ultrasound can be used to guide needle puncture. In addition, a biopsy specimen can be cut when the doctor examines the liver laparoscopically (a fiberoptic tube that piercings into the abdominal cavity).

Leukemia is usually diagnosed with blood and bone marrow tests and typically does not require a liver biopsy.

. Treatment

Treatment depends on the type of cancer: anti-cancer drugs can temporarily shrink tumors and extend life, but they cannot cure cancer. Cancer drugs can be injected into liver arteries, directly into liver cells to create a high concentration of the drug, a technique that is more likely to shrink tumors with fewer side effects, but has not been shown to extend life. Radiation therapy of the liver can sometimes relieve severe pain, but has no other benefits.

If only a single tumor is found in the liver, it can be removed surgically, especially if the tumor is from the intestines, but not all experts approve of this treatment. For most patients with widespread metastatic cancer, doctors can do little more than relieve symptoms.