Pattern of metastasis of primary liver cancer at autopsy: an African series

Out of all the cases seen at autopsy at Ibadan during the study period (1974-1986) ninety-eight patients had primary liver cancer. One of the patients had cholangiocarcinoma. The pattern of metastasis and causes of death of these patients have been studied and discussed in comparison with reports in the literature. The distribution of sites of metastasis in our patients were lungs (37.8%), portal vein (37.8%) and regional lymph nodes (20.4%). We have also shown that the pattern of metastasis of hepatoma arising from cirrhotic liver appears to be different from that of non-cirrhotic liver; the former being more likely to involve the portal vein and regional lymph nodes, while the latter involves more bones. The common causes of death among our patients were bleeding, advanced malignancy and liver failure in 60.2 per cent, 71.4 per cent and 11.2 per cent respectively. Despite recent advances in the management of hepatoma, the above complications remained as major problems.