31 of 2020 | |
32 of 2020 |
SOP bulletin 214 [3]
This SOP covers primary malignant tumours of the liver. These usually arise in the setting of chronic liver disease. The liver is a common site for secondary/metastatic cancer, which is not covered by this SOP.
The diagnosis can be difficult. In patients with cirrhosis or other chronic liver disease it may be possible to make the diagnosis on the basis of specialised imaging, if specific characteristics are demonstrated on MRI, or contrast enhanced CT scanning or ultrasound. In other patients biopsy and histology, or histological confirmation following surgery will be required.
The relevant medical specialist is a general surgeon or gastroenterologist/hepatologist.
* another SOP applies
# non-SOP condition
Many patients have no symptoms specific to the tumour and the condition is detected by regular surveillance of chronic liver disease. Some patients will present with new symptoms such as jaundice or abdominal pain, or may be found to have an upper abdominal mass on examination.
The only SOP worsening factor is for inability to obtain appropriate clinical management. This is typically an aggressive disease, often diagnosed late in its course and having a poor prognosis. Surgical removal is the main treatment, but will not be possible in a significant proportion or patients.
Links
[1] http://www.rma.gov.au/assets/SOP/2020/ed6d86c8e3/031.pdf
[2] http://www.rma.gov.au/assets/SOP/2020/6289aa967d/032.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20bulletin%20214_0.pdf