Diagnostic Dilemma: Does this 49 year old woman have metastatic liver cancer, or are the two liver tumors independent, primary tumors? (LV01-03)

Patient History:

A 49 year old female with Hepatitis B liver cirrhosis was discovered to have two suspicious liver nodules that were biopsied. The pathologist diagnosed liver cancer.

Original Diagnosis:

A well to moderately-differentiated hepatocellular carcinoma is present in both liver core biopsy specimens. It favors independent primary tumors, although metastasis cannot be excluded. Request a PathFinderTG molecular analysis for a more definitive diagnosis. Indeterminate for metastasis.

RedPath Diagnosis:

The patient has metastic liver cancer. Both tumor nodules show an identical pattern of allelic imbalance mutations affecting loci on chromosome arms 1p, 5q, 10q, and 18q. The identical pattern of allelic loss at four loci establishes that these tumors are related, with one being a metastasis of the other.

Generic sample of PathFinderTG® quantitative test results. NOTE: A diagnostic interpretation of the quantitative test results is provided by the RedPath Pathologist.
Click here for test result explanation

Clinical Impact:

For patients with cirrhosis, a liver transplant is often a preferred method of treatment. However if there is a suspicion of metastatic liver cancer, the patient will often be denied a transplant and will rely on alternate treatment methods such as chemoembolization. In this case, the PathFinderTG results established unequivocally the presence of metastatic liver cancer.