Three metastatic pathways of liver cancer

My mother was diagnosed with liver cancer metastasis during a physical examination. I would like to know what liver cancer metastasis is and how it spreads.

The so-called metastasis actually refers to the malignant tumor cells falling off from the primary cancer lesion, being carried to unconnected adjacent parts through various pathways, and continuing to grow and form new secondary cancer lesions of the same nature. This characteristic of cancer should be called diffusion. Diffusion should include infiltration and metastasis. Because metastasis must first be preceded by infiltration, metastasis is also a serious consequence of infiltration.

Clinically, liver cancer rarely directly infiltrates adjacent organs, but it can also spread and infiltrate adjacent tissues and organs, such as the diaphragm, stomach, gallbladder, colon, and pancreas adjacent to the liver. Liver cancer mainly metastasizes through lymphatics, blood circulation, and implantation.

1. Hematogenous metastasis

Intrahepatic hematogenous metastasis is the earliest and most common form of metastasis, which can invade the portal vein and form cancer thrombi. Cancer thrombi that fall off in the liver can cause multiple metastatic lesions, and cancer thrombi that block the main trunk of the portal vein can cause complications such as refractory ascites and portal hypertension. After invading the hepatic vein, liver cancer cells can enter the systemic circulation and metastasize outside the liver, with the highest metastasis rate to the lungs. They can also metastasize to various parts of the body through the blood, with the adrenal glands, bones, kidneys, brain and other organs being more common. Hematogenous metastasis is common in hepatocellular carcinoma.

2. Lymphatic metastasis

The lymphatic system is distributed throughout the body and is the preferred channel for extrahepatic metastasis. Liver cancer can metastasize to the lymph nodes above the clavicle, para-aortic, pancreatic, and spleen, and cholangiocarcinoma metastasis is mostly lymphatic metastasis.

3. Planting transfer

The incidence of implantation metastasis is relatively low. Clinically, it is seen as implantation in the retroperitoneum, forming bloody ascites, and in women, it may be accompanied by ovarian metastatic cancer.