Finding into death of James Lawrence Williams

62y · Male·Extensive liver tumour, primary site not identified

James Williams, a 62-year-old man with intellectual disability, presented to his GP with tiredness, anorexia and fever. Initial assessment suggested possible hepatitis and he was referred to hospital. CT imaging revealed terminal liver cancer with no identifiable primary site. Active treatment was withdrawn and he died 10 days later. The coroner found death resulted from extensive liver tumour. No clinical errors, diagnostic delays, or preventable factors were identified in the assessment or management. The case highlights the challenge of identifying metastatic cancer with unknown primary site in symptomatic patients.