Question:hard
A woman presents with massive pulmonary thromboembolism. The gross appearance of the liver at autopsy is shown. Which of the following statements best characterizes the patient's condition?
A woman presents with massive pulmonary thromboembolism. The gross appearance of the liver at autopsy is shown. Which of the following statements best characterizes the patient's condition?
Show Hint
Which abdominal cancer drains via the portal vein straight to the liver?
Updated On: Jun 24, 2026
- Metastasis from pulmonary embolism
- Angiosarcoma
- Colonic adenocarcinoma with metastasis
- Locally invaded hepatocellular carcinoma
Show Solution
The Correct Option is C
Solution and Explanation
Step 1: A liver covered by many separate nodules of tumor points to secondary spread, because a primary growth would usually form one dominant mass with local infiltration.
Step 2: Venous blood from the large bowel travels via the portal vein straight to the liver. This anatomical route explains why bowel cancers preferentially lodge in hepatic tissue.
Step 3: Roughly $10\%$ to $25\%$ of colorectal cancer patients have liver secondaries at the time of bowel surgery, and surgical resection of isolated hepatic deposits is the most effective therapy.
Step 4: Angiosarcoma is a rare vascular malignancy, hepatocellular carcinoma is typically solitary and locally invasive, and there is no tumor that arises from a pulmonary embolus. Hence the multinodular liver here is metastatic colonic adenocarcinoma.
\[\boxed{\text{Colonic adenocarcinoma with metastasis}}\]
Step 2: Venous blood from the large bowel travels via the portal vein straight to the liver. This anatomical route explains why bowel cancers preferentially lodge in hepatic tissue.
Step 3: Roughly $10\%$ to $25\%$ of colorectal cancer patients have liver secondaries at the time of bowel surgery, and surgical resection of isolated hepatic deposits is the most effective therapy.
Step 4: Angiosarcoma is a rare vascular malignancy, hepatocellular carcinoma is typically solitary and locally invasive, and there is no tumor that arises from a pulmonary embolus. Hence the multinodular liver here is metastatic colonic adenocarcinoma.
\[\boxed{\text{Colonic adenocarcinoma with metastasis}}\]
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