Liver involvement in patients with solid tumors of nonhepatic origin

Metastatic disease represents the most common hepatic neoplasm in the Western world. The most common primary malignancies to spread to the liver are those that originate in the gastrointestinal tract. Of nongastrointestinal malignancies, breast, lung, and melanoma malignancies are most likely to develop hepatic metastases. Some solid tumors, such as renal cell carcinoma, may cause liver-related abnormalities in the absence of hepatic metastases, presumably by way of cytokine-mediated mechanisms. Physical examination, laboratory testing, histologic evaluation, and various radiographic studies are useful in the detection and diagnosis of liver metastases. Multiple treatment modalities are available, including hepatic resection, hepatic arterial chemotherapy, systemic chemotherapy, chemoembolization, cryotherapy, ethanol injection, and radiofrequency ablation.