Hepatocellular carcinoma

Definition

Hepatocellular carcinoma is cancer of the liver.

Alternative Names

Primary liver cell carcinoma; Tumor - liver; Liver cancer; Cancer - liver

Causes

Hepatocellular carcinoma accounts for 80 - 90% of all liver cancers. This type of cancer occurs more often in men than women, usually in people 50 to 60 years old. The disease is more common in parts of Africa and Asia than in North or South America and Europe.

The cause of liver cancer is usually cirrhosis (scarring of the liver). Cirrhosis may be caused by viral hepatitis, primarily hepatitis B and C, alcohol abuse, hemochromatosis, certain autoimmune diseases of the liver, and other diseases that result in chronic inflammation of the liver. The most common cause for cirrhosis in the United States is alcohol abuse.

Symptoms

• Abdominal pain or tenderness, particularly in the right-upper quadrant
• Enlarged abdomen
• Easy bruising or bleeding
• Jaundice (a yellow discoloration of the skin and eyes)

Exams and Tests

• Physical examination shows an enlarged, tender liver.
• A liver biopsy shows hepatocellular carcinoma.
• Serum alpha fetoprotein may be elevated.
• There may be a mass shown on abdominal CT scan.
• A liver scan may indicate an abnormality.
• Liver enzymes (liver function tests) are elevated.

Treatment

Aggressive surgery or liver transplantation may be successful in treating small or slow-growing tumors if they are diagnosed early.

Chemotherapy and radiation treatments are not usually effective but may be used to shrink large tumors so that surgery has a greater chance of success.

Support Groups

The stress of illness can often be eased by joining a support group with members who share common experiences and problems. See liver disease - support group and cancer - support group.

Outlook (Prognosis)

The usual outcome is poor, because only 10 - 20% of hepatocellular carcinomas can be removed completely using surgery. If the cancer cannot be completely removed, the disease is usually deadly within 3 to 6 months, although this varies greatly. Survival much longer than this occasionally occurs.

Possible Complications

• Gastrointestinal bleeding
• Liver failure
• Spread (metastasis) of the carcinoma

When to Contact a Medical Professional

Call your health care provider if persistent abdominal pain develops, particularly if there has been a history of any liver disease.

Prevention

Preventing and treating viral hepatitis may help reduce risk. Avoid excessive alcohol consumption. Certain patients may benefit from hemochromatosis screening.