The cut surface of the liver shows a circumscribed tumour in which there is an irregular cavity lined
by mucosa and containing a number of gall stones.
This man presented at the age of 86 with a short history of loss of appetite and epigastric
pain. His liver was palpable and he admitted to a mild generalized itching. Bilirubin 58, alkaline
phosphatase 630 (20-90), ALT 239 (5-51), AST 100 (5-41). The histology of the lesion is that of
a poorly-differentiated adenocarcinoma. No metastases were demonstrated.