Malignant liver tumours

The liver is commonly affected by malignant tumours, both primary and secondary. The majority of liver tumours are diagnosed radiologically and MRI and CT scan are accurate at detecting even small tumours. Hepatocellular carcinoma (HCC) is the most common primary tumour and often presents on the background of liver cirrhosis. The curative options for HCC are liver resection and transplant. However non-curative management such as radiofrequency ablation (RFA) and trans-arterial chemo-embolization (TACE) can prolong survival in patients not suited to curative management. Cholangiocarcinoma is a less common malignancy but unfortunately has poorer outcomes. It affects the bile ducts and treatment relies on resection of the affected liver and biliary tree, requiring reconstruction of the biliary drainage system. Postoperative morbidity is high and long term survival is often short. Colorectal liver metastases (CLM) are the most common liver tumours. With improvements in preoperative chemotherapy and surgical techniques such as portal vein embolization (PVE) and two stage resections, curative resection with good long term outcomes are often achieved.