№ 26Gastroenterology14 min read
Liver tumors
1. Big picture
A liver tumor may be benign, primary malignant, or metastatic. In adults, the most common malignant tumors found in the liver are metastases, but the most important primary malignant liver tumor for internal medicine exams is hepatocellular carcinoma (HCC).
The examiner usually wants you to think:
Cirrhotic liver + new focal lesion + elevated/normal alpha-fetoprotein (AFP) → HCC until proven otherwise.
High-yield division:
| Group | Examples | Key exam idea |
|---|---|---|
| Benign liver tumors | Hemangioma, focal nodular hyperplasia, hepatocellular adenoma | Often incidental; avoid unnecessary biopsy/surgery |
| Primary malignant tumors | HCC, cholangiocarcinoma, angiosarcoma | HCC is linked to cirrhosis; cholangiocarcinoma is linked to PSC |
| Secondary malignant tumors | Metastases from colorectal, pancreas, stomach, breast, lung, melanoma, neuroendocrine tumors | Most common malignant liver tumors overall |
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