Tumors are abnormal masses of tissue that form when cells begin to reproduce at an increased rate. Both noncancerous (benign) and cancerous (malignant) tumors can develop in the liver.
Benign (noncancerous ) liver tumors are quite common and usually do not produce symptoms. Often, they are not diagnosed until an ultrasound, computed tomography scan, or magnetic resonance imaging scan is performed. There are several types of benign liver tumors, including the following:
Hepatocellular adenoma. This benign tumor is linked to the use of certain drugs. Most of these tumors remain undetected. Sometimes, an adenoma will rupture and bleed into the abdominal cavity, requiring surgery. Adenomas rarely become cancer.
Hemangioma. This type of benign tumor is a mass of abnormal blood vessels. Treatment is usually not required. Sometimes, infants with large liver hemangiomas require surgery to prevent clotting and heart failure.
Focal nodular hyperplasia. This benign tumor is made up of many different types of cells. It is often difficult to tell them apart from real liver cancer.
Nodular regenerative hyperplasia. This benign tumor typically results from the chronic use of certain medications.
A malignant (cancerous) liver tumor that originates in the liver is called primary liver cancer.
Hepatocellular carcinoma, also called hepatoma, is the most common form of primary liver cancer. Chronic infection with hepatitis B and C increases the risk of developing this type of cancer, especially in the setting of cirrhosis. Other causes include certain chemicals, iron, alpha-1 anti-trypsin, and alcoholic liver disease.
The following are the most common symptoms of a liver hepatoma. However, each individual may experience symptoms differently. Symptoms may include:
Large mass can be felt in upper, right part of abdomen
Jaundice. Yellowing of the skin and eyes.
The symptoms of a liver hepatoma may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for a liver hepatoma may include the following:
Liver enzymes and liver function tests. A series of special blood tests that can determine if the liver is functioning properly.
Abdominal ultrasound (also called sonography). A diagnostic imaging technique that uses high-frequency sound waves to create an image of the internal organs. Ultrasounds are used to view internal organs of the abdomen, such as the liver, spleen, and kidneys and to assess blood flow through various vessels.
Computed tomography scan (CT or CAT scan). A diagnostic imaging procedure using a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. They are sometimes able to differentiate between benign and malignant liver tumors as well as tell if the cancer has metastasized to other parts of the body.
Hepatic angiography. X-rays taken after a substance in injected into the hepatic arteries.
Liver biopsy. A procedure in which tissue samples from the liver are removed (with a needle or during surgery) from the body for examination under a microscope.
Specific treatment for liver hepatoma will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the disease
Your tolerance of specific medicines, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
Treatment may include:
Surgery. In some cases, a partial hepatectomy (removal of part of the liver) can be done if the cancer is confined to a small area of the liver.
Tumor ablation. A small needle is inserted into the tumor through the skin. Several methods of ablation are used to destroy the tumor and include: radiofrequency ablation, ethanol ablation, microwave thermotherapy, and cryotherapy.
Embolization therapy. A substance is injected into one of the arteries in the liver that supplies blood to the tumor. Once this is done, the cancer cells die off. Embolization therapy includes: arterial embolization, chemoembolization, and radioembolization.
Radiation therapy. Radiation therapy uses high-energy rays to kill or shrink cancer cells.
Chemotherapy. Chemotherapy uses anticancer drugs to kill cancer cells. Chemotherapy is almost never used to treat liver cancers.
Other, less common primary liver cancers include the following:
Cholangiocarcinoma. A cancer that originates in the lining of the bile channels in the liver or in the bile ducts.
Hepatoblastoma. A cancer in infants and children, sometimes causing the release of hormones that result in early puberty.
Angiosarcoma. A rare cancer that originates in the blood vessels of the liver.
Mixed hepatocellular cholangiocarcinoma. A rare cancer that has characteristics of both hepatocellular carcinoma and cholangiocarcinoma.
When a doctor diagnoses liver cancer, the next step is to determine how far the cancer cells have spread (a process called staging). The National Cancer Institute defines the following stages for primary liver cancer:
Cancer is in the liver only, has not spread, and can be removed completely with surgery.
Cancer is in the liver only, has not spread, but cannot be totally removed, usually due to its location near major blood vessels.
Cancer has spread throughout the liver or to other parts of the body.
Cancer has come back after it was treated.
Cancer that starts in another part of the body and spreads to the liver is called secondary liver cancer. Cancer that has spread to the liver usually originates in the lung, breast, colon, pancreas, or stomach. Leukemia and other blood cancers sometimes also spread to the liver.