Primary Liver Cancer
Primary liver cancer is one of the most common cancers worldwide yet is among the most challenging cancers to treat. While many cancers are declining in the United States, new cases of primary liver cancer are on the rise and are expected to continue to increase over the next two decades. Primary liver cancer starts in the hepatocytes (the main liver cells) and often spreads as a single tumor that slowly infects the rest of the liver. It can, however, spread quickly throughout the entire organ. There are several types of primary liver cancer.
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- Hepatocellular Carcinoma (HCC)
- This is the most common type of primary liver cancer among children and adults. This type begins in the hepatocytes (the main liver cells), but the cancer can spread in different ways. Some liver cancers begin as single tumors that slowly spread throughout the rest of the liver. Other tumors are more aggressive and immediately begin spreading throughout the entire organ. The primary causes of HCC include hepatitis B or C infection, cirrhosis and ingestion of aflatoxin-contaminated food.
- Cholangiocarcinoma
- This form of primary liver cancer starts in the small bile ducts within the liver. Individuals at increased risk for developing this type of cancer include those with gallstones or ulcerative colitis. Certain liver parasites commonly found in parts of Southeast Asia may be associated with this type of cancer.
- Hepatoblastoma
- This is a rare form of liver cancer that primarily affects children younger than 4 years old. Its cause appears to be related to an abnormal gene. Most cases can be treated successfully.
- Angiosarcoma or Hemangiosarcoma
- These are rare forms of liver cancer that originate in the blood vessels of the liver and are associated with exposure to industrial chemicals such as vinyl chloride or the drug thorium dioxide. Because workers are better protected from exposure to carcinogenic chemicals and the use of thorium dioxide has been discontinued for some time, these cancers are not commonly seen today.
Metastatic Liver Cancer
In the United States, even more common than primary liver cancer is metastatic cancer, with origins most commonly found in the colon and rectum. Because the liver is close to a number of significant organs such as the pancreas, gallbladder, stomach, colon, breasts and lungs, and because it is fed from several blood supplies, it is especially vulnerable to metastatic tumors.
Metastatic cancers develop when malignant cells spread from the primary cancer and travel throughout the body in the circulatory or lymphatic system. These cancers are typically named after the organ from which it originated, thus the name metastatic. For instance, cancer that has spread to the liver from the colon is referred to as metastatic colon cancer.
Carcinoid and Neuroendocrine Tumors
Neuroendocrine tumors are mostly very slow growing and often difficult to diagnose. They can originate almost anywhere in the body but are mostly found in the gastrointestinal tract, pancreas and lungs.
The patient may have vague symptoms such as flushing, diarrhea, palpitations, cardiac disease or wheezing as a result of hormone production by the tumor. Because of the delay in diagnosing these tumors, many patients have metastatic disease to the liver at the time of diagnosis.
There are many types of neuroendocrine tumors. The most common are those arising from the gastrointestinal tract (such as carcinoid) or those arising from the pancreas (such as gastrinoma or insulinoma).
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Benign Tumors
A number of noncancerous or benign tumors also may develop in the liver.
- Hemangioma
- The most common type of benign liver tumor, this type affects the liver's blood vessels and typically occurs as a result of a malformation of tissue during fetal development. The majority of hemangiomas do not cause symptoms and do not require treatment.
- Hepatic Adenoma
- This type of tumor begins in the main liver cells called the hepatocytes. Usually, hepatic adenomas don't cause signs or symptoms. However, occasionally, you may experience abdominal pain, a mass in the abdomen or blood loss. Individuals who use birth control pills are more prone to developing this form of tumor. Halting use of birth control pills often causes the tumor to shrink.
- Focal nodular hyperplasia
- This tumor is made up of a combination of several types of cells including hepatocytes, bile duct cells and connective tissue. It is more common in women than men and usually doesn't cause signs or symptoms.