Liver cancer or hepatic cancer (from the Greek hēpar, meaning liver) is a cancer that originates in the liver. Liver cancers are malignant tumors that grow on the surface or inside the liver. Liver tumors are discovered on medical imaging equipment (often by accident) or present themselves symptomatically as an abdominal mass, abdominal pain, jaundice, nausea or liver dysfunction. Liver cancers should not be confused with liver metastases, which are cancers that originate from organs elsewhere in the body and migrate to the liver.
Classification
There are many forms of liver cancer, although many cancers found in the liver are metastases from other tumors, frequently of the GI tract (like colon cancer, carcinoid tumors mainly of the appendix, etc.), but also from breast cancer, ovarian cancer, lung cancer, renal cancer, prostate cancer, etc.
The most frequent liver cancer is hepatocellular carcinoma (HCC) (also named hepatoma, which is a misnomer because adenomas are usually benign). This tumor also has a variant type that consists of both HCC and cholangiocarcinoma components. The cells of the bile duct coexist next to the bile ducts that drain the bile produced by the hepatocytes of the liver. Cancers that arise from the blood vessel cells in the liver are known as hemangioendotheliomas.
As well as mixed tumors, rarer forms of liver cancer include:
—mesenchymal tissue
—Sarcoma
—Hepatoblastoma, a rare malignant tumor, primarily developing in children. Most of these tumors form in the right lobe.
—Cholangiocarcinoma (bile duct cancers), which account for 1 or 2 out of every 10 cases of liver cancer. These cancers start in the small tubes (called bile ducts) that carry bile to the intestine.
—Angiosarcoma and hemangiosarcoma: These are rare forms of cancer that start in the blood vessels of the liver. These tumors grow quickly. Often by the time they are found they are too widespread to be removed. Most patients do not live more than a year after diagnosis.
—Lymphoma of liver: A rare form of lymphoma that usually have diffuse infiltration to liver. It may also form a liver mass in rare occasions.
Signs and symptoms
Cholangiocarcinoma
—sweating
—Jaundice
—Abdominal pain
—Weight loss
—Hepatomegaly
Hepatocellular carcinoma
—Abdominal mass
—Abdominal pain
—Emesis
—Anemia
—Back pain
—Jaundice
—Itching
—Weight loss
—Fever
Causes
Risk factors for adults developing primary liver cancer:
—Hepatitis C is the primary cause of liver cancer.
—Chronic Hepatitis B infection
—Cirrhosis
—Aflatoxin exposure
—Obesity has emerged as an important risk factor as it can lead to steatohepatitis
Risk factors for children developing primary liver cancer:
—Alagille syndrome (associated with HCC)
—Beckwith-Wiedemann Syndrome (associated with hepatoblastoma)
—Familial adenomatous polyposis (associated with hepatoblastoma)
—Glycogen storage diseases (associated with both HCC and hepatoblastoma)
—Hepatitis B infection, associated when contracted in the perinatal period (with transmission at birth) (associated with HCC)
—Low birth weight (associated with hepatoblastoma)
—Progressive familial intrahepatic cholestasis (associated with HCC)
—Trisomy 18, as well as other trisomies (associated with hepatoblastoma)
—Tyrosinemia (associated with HCC)
Prevention
Since hepatitis B or C is one of the main causes of liver cancer, childhood vaccination against hepatitis B may reduce the risk of liver cancer in the future.[7] In the case of patients with cirrhosis, alcohol consumption is to be avoided.