Liver Cancer

Hemangioma

The most common type of benign liver tumors is called hemangiomas, which start in blood vessels. Most hemangiomas of the liver cause no symptoms and do not need treatment. However, some may bleed or become large enough to cause pain and may need to be removed surgically.

Hepatic adenoma

Hepatic adenoma is a benign tumor that starts from the main type of liver cell called hepatocytes. Most do not cause symptoms and do not need treatment. Some eventually do cause problems, such as pain or a mass in the stomach, or blood loss. Because there is a risk that the tumor could rupture, leading to severe blood loss as well as a small risk that it might eventually develop into liver cancer, we may recommend surgery to remove the tumor.

Focal nodular hyperplasia

Focal Nodular Hyperplasia (FNH) is a tumor-like growth made up of several cell types (hepatocytes, bile duct cells, and connective tissue cells). Although FNH tumors are benign, it can be hard to tell them apart from true liver cancers, and we often remove them surgically when the diagnosis is unclear.

Liver cysts

An estimated five percent of the population develop liver cysts. They are benign growths that contain fluid produced by the cell wall of the cyst. Most cysts do not need therapy, but some can grow and be large enough to cause pain. These can be drained laparoscopically as an outpatient procedure to alleviate symptoms.

Hepatocellular carcinoma:

Also known as hepatocellular cancer, or HCC, this is the most common form of liver cancer in adults. It is also sometimes called hepatoma. About 4 of 5 cancers that start in the liver are this type.

Hepatocellular cancer can have different growth patterns:

• A single tumor that grows larger. Only late in the disease does it spread to other parts of the liver.
• Small cancer nodules throughout the liver, not just a single site. This is seen most often in people with cirrhosis (chronic liver damage).

Chronic infection with hepatitis B and C increases the risk of developing this type of cancer. In addition to cirrhosis, other causes include certain chemicals and alcoholism.

Under a microscope, we can distinguish several subtypes of HCC. Most often these subtypes do not affect treatment or the prognosis for survival. However, one of these subtypes, fibrolamellar, is important to recognize. This type is rare, does not affect the entire liver, and make up less than one percent of HCCs diagnosed. Patients with this type are usually younger than age 35 while there is generally a better outlook for this subtype than other forms of HCC.

Bile duct cancer (Intrahepatic cholangiocarcinoma):

The bile duct starts in the liver. Smaller tubes that are like small blood vessels drain bile from the cells in the liver into larger and larger branches, ending in a tube referred to as the common bile duct. Bile duct cancer begins when normal cells in the bile duct change and grow uncontrollably forming a mass called a tumor, which can be benign or malignant. About 10 to 20 percent of liver cancers are bile duct cancers. Surgical removal of these tumors offers the best chance for cure.

Angiosarcoma and hemangiosarcoma

Angiosarcoma and hemangiosarcoma are both rare cancers that begin in cells lining the blood vessels of the liver. People who have been exposed to vinyl chloride or to thorium dioxide are more likely to develop these cancers. It’s also possible that exposure to arsenic or radium could lead to this type of liver cancer. There is also an inherited condition known as hemochromatosis that can also lead to these types of tumors.

Angiosarcomas and hemangiosarcomas can grow quickly. By the time they’re found, these tumors are often too widespread to be removed surgically. Chemotherapy and radiation therapy may help slow the spread of the disease, but these cancers are usually very hard to treat.

Hepatoblastoma

This is a very rare kind of cancer that develops in children, usually in those younger than four years old. The cells of hepatoblastoma are similar to fetal liver cells. About two out of three children with these tumors are treated successfully with surgery and chemotherapy, although the tumors are harder to treat if the cancer has spread outside of the liver.

Secondary or metastatic liver cancer

Most of the time when cancer is found in the liver, it did not start there.  Instead, it spread or metastasized from somewhere else in the body, such as the pancreas, colon, stomach, breast, or the lung. These tumors are named and treated based on where they originated. For example, if your cancer started in the lung and spread to the liver it’s still called lung cancer with spread to the liver, not liver cancer, and it is treated as lung cancer. Treating the cancer according to its origin provides the most optimal treatment with increased success.