Metastasizing to the liver

[TexPre-Med]

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I'm getting many conflicting answers on the most common metastasis to the liver. FA: colon, RR: lung, prof: colon

Is RR off?

 

[SeventhSon]

I'm getting many conflicting answers on the most common metastasis to the liver. FA: colon, RR: lung, prof: colon

Is RR off?

for what it's worth, i think Robbins Review of Pathology also stated that most common metastasis to the liver is from colon. Maybe what RR meant to say is that the most common metastasis from hepatocellular carcinoma is to the lung, which would make sense anatomically.

 

[drblueshades]

All of our pathology lecturers have told us that the most common met TO the liver is from the colon.

 

[45408]

All of our pathology lecturers have told us that the most common met TO the liver is from the colon.

That sounds right. It makes sense, if you think about the portal vein coming off the GI.

 

[JDWflash44]

Goljan claims that in Sabbiston's (sp?) Textbook of Surgery there is a series of 100,000+ autopsies that show that lung cancer metastasizes to liver more often than colon does.("lung beats colon") I've never actually checked his reference though. He says most people say colon, but that they're wrong.

 

[SeventhSon]

Goljan claims that in Sabbiston's (sp?) Textbook of Surgery there is a series of 100,000+ autopsies that show that lung cancer metastasizes to liver more often than colon does.("lung beats colon") I've never actually checked his reference though. He says most people say colon, but that they're wrong.

Well i hate to throw biostats into this, but the odds that some liver met came from lung vs. from the colon, is different from the odds of a colon adeno metastasizing to the liver vs. the odds of a lung cancer metastasizing to the liver. It is possible that this is all consistent... we need to refine our question carefully

 

[PeepshowJohnny]

I hate this type of stuff. It's dummy information people manipulate so whatever you're talking about is important. It's like how you can take an esoteric disease and through enough qualifiers make it sound important "Cancer of the eyelid may sound rare, but it's the number three most common malignancy affecting immigrant Albanian males between thirteen and seventeen"

I'm willing to wager some of the confusion here may arise from the fact the incidence of lung cancer is greater than colon in absolute numbers. It may be, a case per case basis (and I'm speculating here), that colon may metastasize to liver more, but since lung is more common the absolute number of lung cancer mets is greater.

But once again, who cares? How is this information useful to patient care? You see something on the liver, you're going to check pretty much everywhere for a primary. It's not like you only get one chance to guess where it came from.

 

[Blade28]

There are two different, distinct questions being asked in this thread.

Which question are you asking?

"If a liver met is present, where is it most likely to have originated from?" (e.g. lung vs. colon)

or...

"Which organ's cancer is most likely to metastasize to the liver?" (versus metastasizing to another organ, like the brain or the bones)

Very different questions.

 

[SocialistMD]

MSK says that colon cancer is the most common cancer to metastasize to the liver, but I agree with Blade that the answer may lie in the fact that you are looking at answers to two different questions.

 

[-Goose-]

I was just listening to Goljan audio tape on pancreas/hepatobiliary path yesterday and he does indeed say in the tape that the most common source of metastatic liver cancer is from the lung. I thought it was wrong (I was told colon and I think Robbins says colon).

I feel like Goljan gets a decent amount of stuff incorrect, which makes me nervous using RR Path. His explanation of Wilson's disease on the copy of the tapes I have is pretty awful.

 

[cfdavid]

I hate this type of stuff. It's dummy information people manipulate so whatever you're talking about is important. It's like how you can take an esoteric disease and through enough qualifiers make it sound important "Cancer of the eyelid may sound rare, but it's the number three most common malignancy affecting immigrant Albanian males between thirteen and seventeen"

I'm willing to wager some of the confusion here may arise from the fact the incidence of lung cancer is greater than colon in absolute numbers. It may be, a case per case basis (and I'm speculating here), that colon may metastasize to liver more, but since lung is more common the absolute number of lung cancer mets is greater.

But once again, who cares? How is this information useful to patient care? You see something on the liver, you're going to check pretty much everywhere for a primary. It's not like you only get one chance to guess where it came from.

I hear your logic, and feel the frusteration. Also, I suspect you're correct in how you're interpreting this. Most likely, versus most common.....

 

[TRKATK]

I was taught
blood from most body organs->metas to lungs
blood from digestive organs->metas to liver

 

[Chemguync]

If your professor says colon, it's colon.

 

[DrRobert]

Are you asking this question so you can get an answer correct on an exam or in the context of patient care?

In the context of patient care I would think about it like this:

Is the patient a smoker?

Yes - most likely source is lung

No - most likely source is colon

 

[SeventhSon]

If your professor says colon, it's colon.

hahaha so true