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 Primary tumor vs Mets  

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Single tumor is likely to be a primary, while multiple tumors is more likely to be mets. Am I right?

Yet, UW says single tumor in liver is most likely to be mets, most likely from colon. Hence, next step is colonoscopy.

Can someone help with this/

Thank you.


might be (not necessary to be correct) bcs most common liver tumor is metastasis,

and mc primary liver tumor is hepatocellular carcinoma that develops in patients with risk factors such as alcohol abuse, viral hepatitis, in setting of cirrhosis or hemachromatosis

and if pt has liver tumor without all this predisposing things, its likely to be metastasis.

HCC by the way has 3 growth patterns:
Solitary mass - Often large
Multifocal or nodular pattern - Multiple nodules
Diffuse - Multiple, small foci scattered diffusely throughout the liver.


hero wrote:
might be (not necessary to be correct) bcs most common liver tumor is metastasis,

Agree completely. But, I was thinking along lines of solitary and multiple tumors being primary and mets, respectively.[That too, in the qn, it was single large one, ~3cm X 3cm, really seemed like primary.]

Thanks a lot for replying.


sometimes the questions are not written well, like this one, i remember it. it didnt have enough information to be able to think about colon cancer...


The Educational Obj goes like this, and I quote: Isolated liver mass is much more likely to be the result of metastatic disease than primary malignancy of liver.

This is not a case of unclear qn or ambiguous details to base your diagnosis on. This piece of info is plain wrong.

And, this is supposedly the best qn bank out there. Go figure.


1st time i subscribed to UW i spent soo much time checking their answers, sifting thru UpToDate, Harrison's was very time consuming... the end i just "ignored" their weird s**t, because overall you get alot of good stuff for the exam.

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