Liver tumours are distinguished into:
• Benign liver tumours
• Malignant liver tumours, originating in the liver or metastasized from other organs.
Benign liver tumours
Benign liver tumours are frequent and include, among other things, cysts (single or multiple sacs filled with liquid), adenomas (accumulations of benign liver cells) and focal nodular hyperplasia (a combination of biliary tracts, healthy liver cells and connective tissue).
Malign liver tumours
Liver cell carcinoma in particular and a number of more rare types of liver tumours such as haemangioendothelioma are malign liver tumours. In the case of metastasising to the liver the primary tumour is not located in the liver, but cancer cells colonize the liver while the real tumour is located in another organ at another site in the body. Most frequent causes are large bowel, lung, stomach and breast cancer.
Organisation of the care for the patient with a liver tumour
The department of Gastroenterology and Hepatology within Erasmus MC runs the so-called ‘one-stop' outpatient clinic for focal liver lesions. Patients are seen just one time in principle, and during this visit also undergo (contrast) ultrasound study.
Subsequently, if possible in the same week, all available clinical data and imaging material (Contrast enhanced ultrasound/CT/MRI) are discussed in the multidisciplinary liver meeting. This meeting is pivotal in the care for the patient. On these occasions radiologists, oncologists, hepatobiliary and liver transplant surgeons, gastroenterologists and hepatologists together discuss their patients and decide on a well-considered evidence based treatment strategy.
All in all, this approach usually results in a strategic treatment plan within a few days after the patient's visit to the outpatient clinic. Key terms for these meetings are: fast, clear, well-documented and high-quality. The focal liver lesion meeting is a multidisciplinary tumour meeting accredited by the IKN (Comprehensive Cancer Centre of the Netherlands).
The departments of Gastroenterology and Hepatology, Surgery, Oncology, Radiology and Pathology have established an ongoing collaboration in research aimed at improving the care around the patient with a liver tumour.
Specific focus of attention is on the growth characteristics of liver cell adenoma during pregnancy and sub classifications of adenoma to better predict biologic behaviour in the future.