Primary met to the liver

[katieb]

FA says colon, Goljan says lung. I think it's colon, right?

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[bulletproof]

[QUOTE,=katieb]FA says colon, Goljan says lung. I think it's colon, right?[/QUOTE]

Colon (GI), lung, breast....in that order. That is what we were taught, and that is what i find in most texts including Harrisons and Robbins.

 

[CANES2006]

Colon

 

[bigfrank]

FA says colon, Goljan says lung. I think it's colon, right?

you won't be asked this on any Step exam.

 

[Pox in a box]

you won't be asked this on any Step exam.

Hate to have to disagree with you but NBME asked the exact concept on a shelf exam this year. Goljan caused me to get it wrong. He made up for it in other areas.

 

[Idiopathic]

Hate to have to disagree with you but NBME asked the exact concept on a shelf exam this year. Goljan caused me to get it wrong. He made up for it in other areas.

I agree, this is certainly a possibility. However, everyone should understand that colon is more likely to metastasize to the liver, but I believe that more lung CA = more mets. This is a point of contention, so someone should really try to find some stats here.

 

[kaboodle]

Also depends on what kind of cancer. For example, met to the liver could be a krunkenburg tumor of the ovaries. The question must have given some hint on what kind of cancer it is.

 

[imtiaz]

i always just remember enterohepatic circulation, this is a means by which GI malignancies can get to the liver. so GI->liver makes sense to me.

krukenberg tumor classically i thought was ovary->stomach, but an obgyn attending once told me that it has been expanded to ovary->GI.

 

[lapiz007]

this exact question was on my comlex...

 

[Pox in a box]

I agree, this is certainly a possibility. However, everyone should understand that colon is more likely to metastasize to the liver, but I believe that more lung CA = more mets. This is a point of contention, so someone should really try to find some stats here.

I've got some stats and it was dead last (lung).

Liver metastases organ of origin: colon (42%), stomach (23%), pancreas (21%), breast (14%), lung (13%) from Radiology Review Manual.

 

[katieb]

Ironically, I got the question today 2nd block! I laughed out loud. It's too bad that I'll never know for sure whether I got it right or not.

 

[lattimer13]

i got a similar question on my step 1 this week.

 

[Idiopathic]

I think you have to go with lung on that one.

 

[Harrie]

i always just remember enterohepatic circulation, this is a means by which GI malignancies can get to the liver. so GI->liver makes sense to me.

krukenberg tumor classically i thought was ovary->stomach, but an obgyn attending once told me that it has been expanded to ovary->GI.

Krukenberg tumors are signet ring cell adenocarcinomas that arise in the stomach (classically stomach but may include other GI tumors) and then metastasize to the ovary.

 

[Pox in a box]

I think you have to go with lung on that one.

What?

 

[imtiaz]

Krukenberg tumors are signet ring cell adenocarcinomas that arise in the stomach (classically stomach but may include other GI tumors) and then metastasize to the ovary.

sorry, my arrows were mixed up.

 

[Idiopathic]

What?

I just saw your post. All the other stuff I read lists lung CA as more likely to metastasize and more CA overall. I guess its just a tough one to figure out. Whats the official Kaplan answer, anyone?