Prognostic value of instrumental research methods in the diagnosis of complicated forms of liver malignant tumors

Abstract

Objective: To determine prognostic value of instrumental methods in the diagnosis of complicated forms of malignant forms of focal liver lesion.

Material and methods: The experience of treating 112 patients with primary and secondary tumor lesions of the liver was analyzed. Life-threatening complications, such as spontaneous rupture of the tumor node leading to massive intraperitoneal bleeding and cancerous peritonitis, were noted in 32 (28.5%) cases. Clinical and echographic signs of the threat of this complication developing were observed in 26 (23.2%) patient. Ultrasound (US) and CT semiotics of the tumor node rupture included signs of hemoperitoneum, focal heterogeneous formation with the presence of perilesional hematoma, active extravasation of contrast medium, and focal discontinuity of the liver contour at the site of the focal formation.

Results and discussion: Most often, the size of the tumor node exceeded 8.0 cm (in 65% of patients). Protrusion of the tumor through the liver surface was noted in 23 (39.6%) cases. Invasion of the tumor into adjacent organs and tissues was observed in 16 (27.5%) patients. Sites of phlebothrombosis, predominantly in the system of hepatic veins, detected by echo-Dopplerography of liver vessels, were present in 12 (20.6%) patients.

Conclusion: Predictors of spontaneous rupture of the tumor node may include: size of the formation more than 5 cm; protrusion of the tumor through the liver surface; phlebothrombosis by tumor masses, leading to increased intramural pressure; extraliver invasion of the tumor into adjacent organs and tissues.