Abstract
Among tumors causing hepatic metastatic disease, colorectal carcinoma (CRC) plays a very important and distinct role, both clinically and pathologically. The liver is the first and most common of CRC metastasis. CRC metastases to the liver occur in synchronous or metachronous manner, whereby synchronicity of CRC hepatic metastasis is a risk factor associated with poorer outcome. CRC metastatic to the liver has a complex molecular signature that will be employed for risk stratification and new treatment modalities. CRC metastasis to the liver presents a solitary or multiple lesions. The metastases involve the liver lobes with different frequencies, the right being involved more frequently. Typical solitary CRC metastases are bulky masses with a usually expanding growth pattern. The pattern of nodularity and growth patterns have resulted in classification systems for metastases. Large CRC nodules often reveal secondary changes, central necrosis being a very common feature. The tumors can invade the liver capsule and extend into adjacent structures, mainly the diaphragm, resulting in characteristic imaging findings. The metastatic nodules are associated with a distinct peritumoral immune reaction and may elicit formation of a pseudocapsule.
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Zimmermann, A. (2017). Metastatic Liver Disease: Colorectal Carcinomas. In: Tumors and Tumor-Like Lesions of the Hepatobiliary Tract. Springer, Cham. https://doi.org/10.1007/978-3-319-26956-6_107
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