So there are other cancers in the hepatobiliary
system that we have not mentioned yet.
As a quick aside, remember that
the liver is the primary site of metastasis
for all cancers that originate
throughout the GI tract.
This is because all of the blood flow in the
GI tract eventually goes to the portal system
and is filtered by the liver.
So you should remember that, just because
you find a lesion in the liver on imaging,
this does not always mean it
is hepatocellular carcinoma.
So there are many cancers that
commonly metastasize to the liver.
As we mentioned, most GI cancers can
metabolize there including colorectal cancer,
stomach cancer, esophageal
cancer and pancreatic cancer.
On the other hand, other cancers outside of
the GI tract can also metastasize to the liver,
including breast cancer, lung
cancer, ovarian cancer and melanoma,
Another type of cancer that can
affect the hepatobiliary system
is specifically gallbladder
cancer or gallbladder carcinoma.
It is a very rare disease but
is often fatal when diagnosed.
As we mentioned, it is
often diagnosed at late stages
and so patients have very poor
prognosis with this disease.
Risk factors include a history of gallstones, gallbladder
polyps, a condition called 'porcelain gallbladder'
and things like obesity and whether
they are chronic carriers of certain infections.
Patients may present with right upper
quadrant pain, nausea, vomiting, weight loss.
They may also have jaundice and biliary
colic from the obstruction of the biliary tree.
So, the diagnosis, unfortunately
is usually diagnosed at the time
of surgical removal of the
gallbladder by pathology.
And treatment, for limited stage cancers is surgical
removal of the gallbladder with a cholecystectomy.
For those who cannot undergo
surgery or if the cancer is too extensive,
you may do chemotherapy
plus or minus radiation.
And a mainstay of
treatment is palliative care.
Thank you very much for your attention.