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. 1971 Nov 13;4(5784):408-410, 411. doi: 10.1136/bmj.4.5784.408

Diagnosis of Primary Cancer of the Liver

M C Kew, H A Dos Santos, Sheila Sherlock
PMCID: PMC1799483  PMID: 5124443

Abstract

The diagnosis of primary cancer of the liver was reviewed in 75 patients. A definitive diagnosis was made during life in 63% and in a further 20% this condition was suspected though histological confirmation was obtained only at necropsy. The most common presenting complaints were abdominal pain and weight loss and the most frequent findings hepatomegaly and ascites. Less than one-half of the patients were jaundiced and when present it was usually mild. An arterial bruit was heard over the liver in 25% of the patients. A sudden and unexplained deterioration in a patient known to have cirrhosis or haemochromatosis should raise the possibility of a primary hepatic tumour; this occurred in 24% of our patients.

Alpha-fetoprotein was found in the serum of 11 out of 18 cases. The presence of a mass in the liver was frequently confirmed by liver scan, portal venography, or hepatic arteriography, but these showed no features diagnostic of a primary tumour. Liver scan also proved useful in localizing the lesion for biopsy purposes. Definitive diagnosis is dependent on the histological demonstration of the features of the tumour. This can frequently be achieved by percutaneous needle biopsy, which was positive in 38 out of 57 patients. Wedge biopsies were positive in a further nine patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abelev G. I., Assecritova I. V., Kraevsky N. A., Perova S. D., Perevodchikova N. I. Embryonal serum alpha-globulin in cancer patients: diagnostic value. Int J Cancer. 1967 Sep 15;2(5):551–558. doi: 10.1002/ijc.2910020517. [DOI] [PubMed] [Google Scholar]
  2. Alpert M. E., Seeler R. A. Alpha fetoprotein in embryonal hepatoblastoma. J Pediatr. 1970 Dec;77(6):1058–1060. doi: 10.1016/s0022-3476(70)80094-4. [DOI] [PubMed] [Google Scholar]
  3. Bersohn I., Purves L. R., Geddes E. W. Liver-function tests in primary cancer of the liver in the Bantu. S Afr Med J. 1969 Oct 4;43(40):1219–1225. [PubMed] [Google Scholar]
  4. Bourreille J., Metayer P., Sauger F., Matray F., Fondimare A. Existence d'alpha foeto protéine au cours d'un cancer secondaire du foie d'origine gastrique. Presse Med. 1970 Jun 6;78(28):1277–1278. [PubMed] [Google Scholar]
  5. Clain D., Wartnaby K., Sherlock S. Abdominal arterial murmurs in liver disease. Lancet. 1966 Sep 3;2(7462):516–519. doi: 10.1016/s0140-6736(66)92878-9. [DOI] [PubMed] [Google Scholar]
  6. FENSTER L. F., KLATSKIN G. Manifestations of metastatic tumors of the liver. A study of eighty-one patients subjected to needle biopsy. Am J Med. 1961 Aug;31:238–248. doi: 10.1016/0002-9343(61)90112-7. [DOI] [PubMed] [Google Scholar]
  7. Foy H., Kondi A., Parker A. M., Stanley R., Venning C. D. The alpha-fetoprotein test in pregnant women, women on oral contraceptives, newborn babies, and pyridoxine-deprived baboons. Lancet. 1970 Jun 20;760(1):1336–1337. doi: 10.1016/s0140-6736(70)91925-2. [DOI] [PubMed] [Google Scholar]
  8. Geffroy Y., Denis P., Colin R., Sauger F., Matray F., Fondimare A. Présence d'alpha 1-foeto-protéine chez l'adulte au cours d'une hépatite virale traitée par corticothérapie. Presse Med. 1970 May 16;78(24):1107–1108. [PubMed] [Google Scholar]
  9. HARVEY A. M., IBER F. L., ROSS R. S. The serum alkaline phosphatase in chronic infiltrative disease of the liver. Am J Med. 1956 Dec;21(6):850–856. doi: 10.1016/0002-9343(56)90099-7. [DOI] [PubMed] [Google Scholar]
  10. Houstek J., Masopust J., Kithier K., Rádl J. Hepatocellular carcinoma in association with a specific fetal alpha-1-globulin, fetoprotein. J Pediatr. 1968 Feb;72(2):186–193. doi: 10.1016/s0022-3476(68)80307-5. [DOI] [PubMed] [Google Scholar]
  11. Man B., Kraus L., Pikielny S. Catheterization of the umbilical vein and its use for hepatography. Clin Radiol. 1971 Jul;22(3):350–360. doi: 10.1016/s0009-9260(71)80084-3. [DOI] [PubMed] [Google Scholar]
  12. Mawas C., Kohen M., Lemerle J., Buffe D., Schweisguth O., Burtin P. Serum alpha-1 foeto-protein (fetuin) in children with malignant ovarian or testicular teratomas. Preliminary results. Int J Cancer. 1969 Jan 15;4(1):76–79. doi: 10.1002/ijc.2910040110. [DOI] [PubMed] [Google Scholar]
  13. Moseley R. V. Primary malignant tumors of the liver: a review of the clinical and pathologic characteristics of 47 cases and a discussion of current diagnostic techniques and surgical management. Surgery. 1967 May;61(5):674–686. [PubMed] [Google Scholar]
  14. Purves L. R., Bersohn I., Geddes E. W. Serum alpha-feto-protein and primary cancer of the liver in man. Cancer. 1970 Jun;25(6):1261–1270. doi: 10.1002/1097-0142(197006)25:6<1261::aid-cncr2820250603>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  15. Purves L. R., Macnab M., Bersohn I. Serum alpha-feto-protein. I. Immunodiffusion and immuno-assay results in cases of primary cancer of the liver. S Afr Med J. 1968 Nov 2;42(42):1138–1141. [PubMed] [Google Scholar]
  16. Rake M. O., Eddleston A., Pagaltsos S., Williams R., Osborne S. B. The value of scintiscanning in the diagnosis of hepatic tumours using both selenomethionine and technetium. Br J Radiol. 1970 Nov;43(515):830–830. [PubMed] [Google Scholar]
  17. Reuter S. R., Redman H. C., Siders D. B. The spectrum of angiographic findings in hepatoma. Radiology. 1970 Jan;94(1):89–94. doi: 10.1148/10.1148/94.1.89. [DOI] [PubMed] [Google Scholar]
  18. Simpson J. A. Liver friction rub. A useful sign in the diagnosis of hepatic metastases. Am J Dig Dis. 1971 Jan;16(1):39–40. doi: 10.1007/BF02233788. [DOI] [PubMed] [Google Scholar]
  19. TATARINOV Iu S. OBNARUZHENIE EMBRIOSPETSIFICHESKOGO ALPHA-GLOBULINA V SYVOROTKE KROVI BOL'NOGO PERVICHNYM RAKOM PECHENI. Vopr Med Khim. 1964 Jan-Feb;10:90–91. [PubMed] [Google Scholar]
  20. Uriel J., de Nechaud B., Stanislawski-Birencwajg M., Masseyeff R., Leblanc L., Loisillier F., Quenum C., Grabar P. Le diagnostic du cancer primaire du foie par des méthodes immunologiques. Presse Med. 1968 Jun 29;76(28):1415–1417. [PubMed] [Google Scholar]

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