About Liver Cancer
Primary Liver Cancer
- Hepatocellular carcinoma (HCC)
Also known as hepatoma, HCC is the fifth most common cancer in the world, and has been increasing in prevalence in the United States, primarily because of the increased number of people with cirrhosis of the liver due to hepatitis C infection. HCC is a cancer of the hepatocyte, which is one of the main functional cell types in the liver.
Other Primary Liver Cancers
There are several different types of liver cancer. HCC is a primary liver cancer that originates from liver cells. This most often occurs in people who have chronic liver disease and cirrhosis. HCC should be distinguished between other forms of liver cancer, such as metastatic tumor (cancers that have spread to the liver from another primary site, such as the lung or breast). Other, less common, types of primary liver cancers include:
- Cholangiocarcinomas (cancer of the bile ducts)
- Adenocarcinomas (other glands within the liver)
- Sarcomas and angiosarcomas (connective tissue within the liver)
- Hemangioendotheliomas (blood vessels within the liver)
- Fibrolamellar carcinoma
Is a variation of HCC that is found in non-cirrhotic livers, usually in younger patients between the ages of 20 and 40 years. In fact, these patients have no associated liver disease and no risk factors have been identified. The alpha-fetoprotein in these patients is usually normal. The appearance of fibrolamellar carcinoma under the microscope is quite characteristic. That is, broad bands of scar tissue are seen running through the cancerous liver cells. The important thing about fibrolamellar carcinoma is that it has a much better prognosis than the common type of HCC. Thus, even with a fairly extensive fibrolamellar carcinoma, a patient can have a successful surgical removal.
Secondary Liver Tumors
- Hepatic colorectal Metastasis
Over the past decade there has been an increasing acceptance of liver resection as the best treatment for hepatic colorectal metastases. Liver resection is now a well-controlled procedure with low mortality rates.
- Neuroendocrine Tumors
Islet cell carcinoma and carcinoid tumors are rare, accounting for less than 1% of all malignant disorders in the United States. It is estimated that fewer than 2,000 new cases occur in the U.S. each year. Compared with more common malignant disorders, these have an indolent natural history and can secrete peptides, resulting in devastating clinical syndromes. Aggressive therapy is recommended to alleviate moderate symptoms or to avert impending hepatic compromise.
- Benign Liver Tumors
Liver tumors can be benign or malignant. Benign tumors are masses of tissue but they are not cancer. They are usually not harmful and do not spread to other parts of the body, and include: cysts, hemangiomas, FNH, and adenomas.