• This is the external surface of the liver showing multiple yellow nodules.

• Such nodules are usually metastatic cancer but abscesses can have similar appearance.

• Note that the intervening parenchyma is noncirrhotic.

• The multiplicity of the lesions and absence of cirrhosis indicate that the neoplasms are metastatic as opposed to primary.

•The liver is a frequent site of metastases from various organs, primarily the gastrointestinal tract, the lung and breast.

•Metastases can be brought to the liver through the systemic blood or through the portal circulation.

•Implantation on the surface of the liver may occur, particularly in ovarian malignancies.

•Common

•Evidence of compromise of liver function may be late.

•The patient may feel a sense of fullness or dull pain in the right upper quadrant
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•Metastases often tend to be multiple, nodular and clearly demarcated from the rest of the liver tissue.

•Very often, the growth of the tumor outstrips blood supply with the development of central necrosis.

•This central necrosis is visible grossly as an area of umbilication of the tan to white nodules.

•The umbilication is particularly obvious on the cut surface.

•Depending on the rate of the growth of the tumor, necrosis and hemorrhage can often be seen.

•The involvement of the liver by metastatic tumor growth can be quite extensive.

•In some cases, as much as 80% of the liver parenchyma may be replaced by the tumor.

•Histologically, the tumor recapitulates the histology of the primary lesion.

•The liver parenchyma between the tumor nodules shows evidence of compression and often of an inflammatory infiltrate, predominantly lymphocytic in nature.

• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 882

• Harrison^s Principles of Internal Medicine, 13th Ed: Isselbach et. al. (eds). New York, McGraw-Hill, 1994, pp.1497

• Current literature from PubMed at National Library of Medicine