Patient presents with complaints consistent with metastatic liver cancer, including right upper quadrant pain, abdominal distension, fatigue, and unintentional weight loss.  Physical examination revealed hepatomegaly and palpable liver masses.  The patient's medical history includes [Insert primary cancer site, e.g., colorectal cancer] diagnosed in [Date].  Laboratory findings show elevated alpha-fetoprotein (AFP) and liver function tests (LFTs), including aspartate aminotransferase (AST) and alanine aminotransferase (ALT).  Imaging studies, specifically a contrast-enhanced computed tomography (CT) scan of the abdomen and pelvis, confirmed the presence of multiple hepatic lesions consistent with metastatic disease.  The diagnosis of metastatic liver cancer is established based on imaging findings, elevated tumor markers, and the known history of primary cancer.  Differential diagnoses included primary liver cancer, benign liver lesions, and cirrhosis.  These were ruled out based on imaging characteristics and laboratory results.  Treatment options discussed include systemic chemotherapy, targeted therapy, hepatic artery embolization, and palliative care.  The patient's prognosis was discussed, and a treatment plan was formulated based on the patient's performance status, disease burden, and treatment goals.  Referral to oncology and palliative care specialists has been initiated.  Patient education regarding metastatic liver cancer, treatment options, and potential complications was provided.  Follow-up appointment scheduled in two weeks to discuss treatment progress and symptom management.