Malignant tumors within the liver are among the most difficult problems that physicians treat, and there is no single treatment that is always effective. The total removal of tumors in the liver is frequently not feasible, either because of their size or the total number of tumors. Even when tumors are removed it is common for new tumors to show up within the liver at a later time. A minimally invasive surgical treatment of liver tumors called Radio-frequency Ablation (RFA) can kill cancerous growths within the liver without actually removing them. This type of treatment involves the placement of specialized needles directly into the tumor, which generate heat that kills the tumor cells. The technique can be performed as a laparoscopic procedure using ultrasound to guide the placement of the needle. RFA has been shown to reliably destroy tumors that are as large as 4 to 5 centimeters in diameter (up to two inches). However, the larger the tumor, the more difficult it is to destroy completely.
The liver is the largest organ in the abdomen and is located beneath the diaphragm in the uppermost part of the abdomen. The liver performs a number of vital functions, including filtering toxic substances that are absorbed into the bloodstream through the intestine. Since all blood coming from the intestinal tract passes first through the liver, cancer cells that escape from intestinal tumors often spread directly into the liver. These tumors are called hepatic metastases. While intestinal cancers are the most common source of liver cancers, virtually any type of cancer has the potential to spread to the liver. Malignant tumors can also arise within the liver itself and occur much more frequently in people who have other underlying liver diseases, such as cirrhosis.
Tumors in the liver generally cause few if any symptoms, and because the liver is so large, it is capable of performing its functions normally despite the presence of one or more tumors growing within it. Only after they have grown quite large do they begin to interfere with one of the liver’s functions. If a tumor blocks the flow of bile through the main bile ducts the result can be jaundice of the eyes and skin. This can also occur when enlarging tumors replace most of the normal liver tissue. Occasionally, pain in the upper abdomen, flank or back can result from enlarging tumors in the liver.
Blood tests that measure the function of the liver are non-specific, but when abnormal they may indicate the presence of tumors. So whenever liver tumors are suspected it is necessary to get actual images of the liver using a CAT scan(Computerized Axial Tomogram) or an MRI (Magnetic Resonance Imaging). A PET scan (Positron Emission Tomography) can also be used to identify the presence of malignant tumors, but may not be as accurate as other tests in measuring the exact size of the tumors. Perhaps the most sensitive test is ultrasound when used during surgery. By placing an ultrasound probe directly on the surface of the liver during surgery it is possible to identify tumors that are smaller than a BB.
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