Melanoma of the liver is one of the most dangerous of malignant tumors. The presented type of disease often occurs in the form of metastases in melanoblastoma in other organs of the human body. Such a diagnosis can be easily made on the basis of a biopsy, which determines the amount of black accumulations of melanin in the liver. In most cases, this melanoma is difficult to treat, and the prognosis is usually poor.
Today, liver melanoma is rare. The clinical picture of this disease is very similar to hepatoma, the diagnosis of which can be confirmed by a standard biopsy procedure. It is extremely rare to diagnose liver sarcoma, which is characterized by a fulminant course. With metastasis, secondary liver cancer can occur. Usually, the growth of metastases in this organ significantly outstrips the growth of the primary focus itself, while it extremely complicates the rapid establishment of the correct diagnosis.
The clinical picture of the disease consists of an accurate picture of the primary as well as secondary lesions. At the same time, there are seals in the liver, it is enlarged, has a lumpy structure and is painful. At this stage, not only liver dysfunctions are encountered, but also jaundice, splenomegaly and ascites. With the help of special instrumental research methods, secondary cancer can be detected. These include targeted biopsy, laparoscopy, angiography, and scanning.
In this case, palliative treatment is used. Chemotherapy is often used for temporary improvement. The prognosis is often poor.
It has been proven that with an increased size, liver functions are preserved. Compression of the intrahepatic bile ducts is not always accompanied by jaundice. As a rule, the necessary outflow of bile is carried out through the remaining unaffected ducts. A slight increase in the level of bilirubin can be observed, which is above 2 mg% in serum. This indicates sufficient patency of all large bile ducts in the main area of the hepatic hilum.
A slight increase in the activity of LDH or ALP is attributed to the main biochemical criteria for organ damage. An increase in the level of serum transaminases is also possible. The likelihood of the absence of metastases is determined by transaminase and a certain concentration of bilirubin in serum. The amount of serum globulins, as a rule, increases slightly.
In some patients, carcinoembryonic antigen can be detected in serum. However, practically all patients have neutrophilic leukocytosis, due to which mild anemia is possible.
The diagnostic value of a puncture liver biopsy is carried out with CT or ultrasound under image control. Often, the tumor tissue of the organ has a rather loose consistency and a characteristic white color. If necessary, instead of a column of tumor tissue, you can also examine detritus or a small blood clot to identify dangerous tumor cells.
It should be mentioned that modern histological studies do not always allow us to accurately establish the existing localization of the primary tumor. In the case of severe anaplasia, metastasis is practically impossible. A special cytological study of drug prints and aspirated fluid obtained from a biopsy significantly increases the diagnostic value of this method.
Plain X-ray of the abdomen helps to reveal the enlarged liver. In this case, the diaphragm may be slightly raised or have rather uneven contours. In rare cases, there is significant calcification of the primary cancer, as well as hemangiomas or metastases of cancer of the bronchi, glands and colon.
The standard scanning procedure helps to identify serious lesions, the diameter of which exceeds 2 cm. It is also important to establish the exact size of the tumor nodes, their location and number. Such a procedure is extremely necessary for an accurate assessment of the possibility of organ resection. Often, ultrasound metastases look like echogenic foci. Intraoperative ultrasound is indicated to diagnose all metastases.
Usually, in any patient with a diagnosis of a primary tumor and with a possible suspicion of existing metastases, it is not possible to confirm such a suspicion. Elevated bilirubin levels can only indicate small metastatic liver lesions. It can also be determined by analysis of alkaline phosphatase and serum transaminase activity. In this case, the specialist prescribes not only liver aspiration biopsy, but also peritoneoscopy and scanning.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".