Liver cancer can come from the liver parenchyma as well as other structures within the liver such as the bile duct, blood vessels and immune cells. There are many sub-types of liver cancer, the most common of which are described below. Hepatocellular carcinoma Liver tumor types by relative incidence in adults in the United States (liver cancers in dark red color). The most frequent liver cancer, accounting for approximately 75% of all primary liver cancers, is hepatocellular carcinoma (HCC). HCC is a cancer formed by liver cells, known as hepatocytes, that become malignant. In terms of cancer deaths, worldwide HCC is considered the 3rd most common cause of cancer mortalities. In terms of HCC diagnosis, it is recommended that people with risk factors (including known chronic liver disease,<unk> , etc.) should receive screening ultrasounds. If the ultrasound shows a focal area that is larger than 1 centimeter in size, patients should then get a triple-phase contrast-enhanced CT or MRI imaging. HCC can then be diagnosed radiologically using the Liver Imaging Reporting and Data System (LI-RADS). There is also a variant type of HCC that consists of both HCC and cholangiocarcinoma. Intrahepatic cholangiocarcinoma Cancer of the bile duct (cholangiocarcinoma and cholangiocellular cystadenocarcinoma) account for approximately 6% of primary liver cancers. Intrahepatic cholangiocarcinoma (CCA) is an epithelial cancer of the intra-hepatic biliary tree branches. Intrahepatic CCA is the second leading cause of primary liver cancer. It is more common in men and usually is diagnosed in 60-70 year olds. Risk factors for development of intrahepatic CCA include opisthorchus viverrini infection, Clonorchis sinensis infection, sclerosing cholangitis, choledochal cysts, past procedures of the biliary tree, exposure to thorotrast and dioxins, and<unk> . This cancer is usually asymptomatic until the disease has progressed. Symptoms include abdominal pain, night sweats, weight loss, and fatigue. Liver markers that can be increased with intrahepatic CCA are carcinoembryonic antigen (CEA), CA19-9, and CA-125. Angiosarcoma and hemangiosarcoma These are rare and aggressive liver cancers, yet are the third most common primary liver cancer making up 0.1-2.0% of primary liver cancer. Angiosarcoma and hemangiosarcoma of the liver come from the blood vessel's endothelial layer. These tumors have poor outcomes because they grow rapidly and metastasise easily. They are also hard to diagnose but are typically suspected on CT or MRI imaging that shows focal lesions with differing amounts of echogenicity (these tumors have a lot of bleeding or hemorrhage and subsequent dying of tissue (necrosis)). Biopsy with histopathological evaluation yields the definitive diagnosis. While the cause is often never identified (75% are idiopathic), they are associated with exposures to substances such as vinyl chloride, arsenic, thorotrast (e.g. occupational exposure). Radiation is also a risk factor. In adults, these tumors are more common in males; however, in children they are more common in females. Even with surgery prognosis is poor with most individuals not living longer than six months after diagnosis. Only 3% of individuals live longer than two years. Hepatoblastoma Another type of cancer formed by liver cells is hepatoblastoma, which is specifically formed by immature liver cells. It is a rare malignant tumor that primarily develops in children, and accounts for approximately 1% of all cancers in children and 79% of all primary liver cancers under the age of 15. Most hepatoblastomas form in the right lobe. Metastasis to liver Many cancers found in the liver are not true liver cancers but are cancers from other sites in the body that have spread to the liver (known as metastases). Frequently, the site of origin is the gastrointestinal tract, since the liver is close to many of these metabolically active, blood-rich organs near to blood vessels and lymph nodes (such as pancreatic cancer, stomach cancer, colon cancer and carcinoid tumors mainly of the appendix), but also from breast cancer, ovarian cancer, lung cancer, renal cancer, prostate cancer. Children The Children's Oncology Group (COG) has developed a protocol to help diagnose and manage childhood liver tumors.
complications of Cirrhosis
complications of Hepatitis
complications of Acute liver failure
complications of Hepatitis B
complications of Hepatitis A
medical cause of Liver cancer
medical cause of Cirrhosis
complications of Hepatitis E