Liver & intrahepatic bile ducts
Other malignancies
Metastases
Author: Shilpa Jain, M.D.
Topic Completed: 1 August 2012
Minor changes: 30 September 2020
Copyright: 2002-2021, PathologyOutlines.com, Inc.
PubMed Search: Metastases to liver[TI]
Table of Contents
Definition / general | Case reports | Gross description | Gross images | Microscopic (histologic) description | Metastatic carcinomatous cirrhosis | Breast carcinoma metastatic to liver | Colon carcinoma metastatic to liver | Gastrointestinal stromal tumor (GIST) metastatic to liver | Hepatoid adenocarcinoma metastatic to liver | Melanoma metastatic to liver | Ocular melanoma metastatic to liver | Pancreaticobiliary metastases to liver | Squamous cell carcinoma metastatic to liverCite this page: Jain S. Metastases. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/livertumormet.html. Accessed January 22nd, 2021.
Definition / general
- In U.S., only 2% of hepatic malignancies in noncirrhotic liver are hepatic primaries (i.e. 98% are metastases) vs. 77% are hepatic primaries in cirrhotic liver
- Direct extension is common from tumors of extrahepatic bile ducts, gallbladder, pancreas and stomach
- Metastases in adults often from breast, colon, lung, pancreas; in children from neuroblastoma, rhabdomyosarcoma, Wilms tumor
- Unknown primary is often determined to be from lung, pancreas, stomach
- Metastatic nodules tend to outgrow their blood supply and produce central necrosis and umbilication
- Symptoms often of abdominal pain, ascites and jaundice; portal hypertension less common
- Survival usually less than 1 year, longer if primary is neuroendocrine carcinoma or neuroblastoma; also some cases of colon carcinoma with resection of hepatic metastases
- Should compare metastatic tumor to prior malignancies
Case reports
- 60 year old woman with female adnexal tumor of probable Wolffian origin metastatic to liver (Arch Pathol Lab Med 2000;124:431)
Gross description
- 90% are multiple, variable size, may replace entire liver and locally elevate the capsule or not be visible on external surface
- Often hemorrhage and necrosis; extensive hemorrhage suggests choriocarcinoma, angiosarcoma or thyroid carcinoma
- Cannot determine malignancy based on gross appearance only
Gross images
Images hosted on other servers:
Multiple metastases
Microscopic (histologic) description
- Sinusoidal dilation, cholestasis, portal lymphocytic infiltrate or tumor
Metastatic carcinomatous cirrhosis
Definition / general
Case reports
- Metastatic carcinoma to liver, often from breast, that incites an extensive fibrotic reaction simulating cirrhosis
Case reports
- 38 year old woman with infiltrating ductal carcinoma of breast with associated florid fibrosis (Arch Pathol Lab Med 2001;125:1084)
Breast carcinoma metastatic to liver
Definition / general
Microscopic (histologic) images
Images hosted on other servers:
- Posttreatment metastases produce coarsely lobulated appearance known as hepar lobatum, associated with syphilis
- Estrogen receptor 35% sensitive and highly specific; progesterone receptor neither sensitive nor specific (Arch Pathol Lab Med 2003;127:1591)
- Mammoglobin+ and GCDFP15+
Microscopic (histologic) images
Images hosted on other servers:
Metastatic breast carcinoma to liver
Colon carcinoma metastatic to liver
Definition / general
Case reports
Gross description
Gross images
Images hosted on other servers:
Microscopic (histologic) description
- Resection of metastases may improve long term survival
Case reports
- 62 year old man with rectal polyp with bone and liver metastases (Am J Surg Pathol 1999;23:838)
Gross description
- Large umbilicated nodules with extensive necrosis and fibrosis, variable calcification
Gross images
Images hosted on other servers:
Colonic adenocarcinoma metastases
Microscopic (histologic) description
- Tubular, papillary or cribriform patterns of columnar cells with basophilic cytoplasm and elongated nuclei, extensive necrosis
Gastrointestinal stromal tumor (GIST) metastatic to liver
Microscopic (histologic) description
Positive stains
Negative stains
- Polygonal, spindle to epithelioid cells
Positive stains
Negative stains
Hepatoid adenocarcinoma metastatic to liver
Definition / general
Microscopic (histologic) images
Images hosted on other servers:
Positive stains
Negative stains
- May arise in lung or stomach
Microscopic (histologic) images
Images hosted on other servers:
Gastric hepatoid adenocarcinoma metastatic to liver
Positive stains
- AFP, CK8, CK19 and CK20 (Am J Surg Pathol 2003;27:1302)
Negative stains
Melanoma metastatic to liver
Microscopic (histologic) description
Microscopic (histologic) images
Images hosted on other servers:
- May replace hepatic cords and grow in trabecular pattern with endothelial lining
Microscopic (histologic) images
Images hosted on other servers:
Uveal melanoma
Ocular melanoma metastatic to liver
Microscopic (histologic) images
Contributed by Dr. Raul Gonzalez
Contributed by Dr. Raul Gonzalez
70 year old woman with liver mass
Pancreaticobiliary metastases to liver
Microscopic (histologic) description
- Atypical angulated glands with desmoplasia
Squamous cell carcinoma metastatic to liver
Case reports
Gross description
- 76 year old man with primary tumor in large intestine (Arch Pathol Lab Med 2001;125:1251)
Gross description
- Soft nodules due to necrosis and keratinization
