Hepatocellular carcinoma involves a malignant tumor of the liver.

Alternative Names

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

Causes, incidence, and risk factors

Hepatocellular carcinoma accounts for 80% to 90% of all liver cancers. It occurs more often in men than women and occurs mostly in people 50 to 60 years old. The disease is more common in parts of Africa and Asia than in North and South America and Europe. The cause of liver cancer is unknown, but contributing factors include chronic liver disease , viral hepatitis (especially hepatitis B and C), hemochromatosis , known hepatic (liver) carcinogens, and toxins (mycotoxins) found in foods in parts of Africa and Asia. The incidence is about 4 in 10,000 people.

Signs and tests

Physical examination

shows an enlarged, tender liver.

A

liver biopsy shows hepatocellular carcinoma.

Serum alpha fetoprotein

is 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. Hepatocellular carcinoma may also alter the following test results:

Porphyrins; urine

PBG

Leucine aminopeptidase - serum

Leucine aminopeptidase - urine

Gamma-glutamyl transpeptidase

Gall bladder radionuclide scan

Delta-ALA

Bilirubin; urine

AST

ALT

Alpha-1 antitrypsin

5'-N'Tase

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 helped by joining a support group where members share common experiences and problems. See liver disease - support group and cancer - support group .

Expectations (prognosis)

The usual outcome is poor, because only 10% to 20% of hepatocellular carcinomas can be removed completely using surgery. If the cancer cannot be completely removed, the disease is usually fatal within 3 to 6 months.

Complications

Gastrointestinal bleeding

Liver failure

Spread (

metastasis ) of the carcinoma

Calling your health care provider

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

Prevention

Control of known hepatic carcinogens may have a preventive effect. Prevention and treatment of viral hepatitis may be beneficial in reducing risk.