A tumor in which the cancer starts during adulthood in cells in the liver. Also called hepatocellular carcinoma or hepatoma.
Primary liver cancer is different from cancer that has metastasized (spread) from another place in the body to the liver.
The signs and symptoms may include a hard lump just below the rib cage on the right side (from swelling of the liver), discomfort in the upper abdomen on the right side, pain around the right shoulder blade, or yellowing of the skin (jaundice).
There is often an increase in the blood levels of alpha-fetoprotein (AFP) and alkaline phosphatase. A rapid deterioration of liver function may be the only clue to the presence of the tumor.
Hepatocellular carcinoma is potentially curable by surgery, but surgery is the treatment of choice for only a small fraction of patients who have localized disease. Laparoscopy may detect metastatic disease, tumor in both lobes of the liver, or an inadequate liver remnant, and avoid the need for open surgery to explore the liver .Liver transplantation can be curative as well, but is only appropriate for 5% of patients presenting with a hepatoma.
Therapy other than surgery is best as part of a clinical trial. Such trials evaluate the efficacy of systemic or infusional chemotherapy, hepatic artery ligation or embolization, percutaneous ethanol (alcohol) injection, radiofrequency ablation, cryotherapy (freezing the tumor), and radiolabeled antibodies, often in conjunction with surgical resection (removal) and/or radiation therapy.
The prognosis (outlook) depends on the degree of local tumor replacement and the extent of liver function impairment.
Primary liver cancer (hepatocellular carcinoma) is the most common cancer in some parts of the world. It is still relatively uncommon in the US but its incidence is rising, principally in relation to the spread of hepatitis B and hepatitis C. People who have a disease of the liver called cirrhosis are also more likely to get adult primary liver cancer. The iron storage disease hemochromatosis also increases the risk of developing hepatocellular carcinoma.
Hepatitis B and C appear to be the most significant causes of hepatocellular carcinoma worldwide. People who have both hepatitis B and hepatitis C may be at a higher risk if they consume more than 3 oz. (80 grams) of alcohol a day. A first-degree relative with hepatocellular carcinoma also increases the risk.
Hepatocellular carcinoma is associated with cirrhosis in 50% to 80% of patients; 5% of cirrhotic patients eventually develop hepatocellular cancer.
Aflatoxin has also been implicated as a factor in the etiology (causation) of primary liver cancer in parts of the world where this mycotoxin – a toxin from a mold infestation-occurs in high levels in food.
Workers exposed to vinyl chloride before controls on vinyl chloride dust were instituted developed sarcomas in the liver, most commonly angiosarcomas.
- Liver disease
Cirrhosis, or scarring of the liver Inflammation (hepatitis) from infectious (hepatitis B, hepatitis C) or non-infectious causes (chemical or autoimmune hepatitis) Tumors, benign and malignant (liver cancer) Metabolic disorders Alcohol abuse is one leading cause of liver disease. Infections, poisons, and inherited (genetic) conditions can also cause diseases of the liver. In most patients with […]
- Liver Failure
McGraw-Hill Professional, 2012.
- Liver of pregnancy, acute fatty
a deficiency of the enzyme long-chain-3-hydroxyacyl-CoA dehydrogenease (LCHAD). The mother and father have half the normal LCHAD activity, and the fetus has no LCHAD activity. This metabolic disease in the baby’s liver causes the fatty liver disease in the mother.
- Liver pain
Pain coming from the liver. The liver does not contain nerve fibers that sense pain. Therefore, liver tissue can be cut, burned, or compressed without causing pain. There are pain fibers, however, in the liver’s capsule, a thin layer of tissue that surrounds the liver tissue itself. The pain fibers of the capsule are stimulated […]
- Liver shunt
Transjugular, intrahepatic, portosystemic shunt (TIPS), is a shunt (tube) placed between the portal vein which carries blood from the intestines to the liver and the hepatic vein which carries blood from the liver back to the heart. It is used primarily (but not exclusively) in patients with cirrhosis in which the scar tissue within the […]