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Types of Liver Tumors
Tumors are abnormal growths of tissue that form when cells begin to reproduce at an increased rate. Tumors in the liver can be either non-cancerous (benign) or cancerous (malignant). Malignant tumors of the liver fall into two categories. Cancerous tumors that start in the liver are known as primary liver cancer. Those that spread to the liver from other cancers are known as metastatic or secondary liver tumors
Over 250,000 Americans are diagnosed with liver tumors each year. Once considered a death sentence, patients are living - and living well - in spite of liver tumors.
Benign Liver Tumors
Primary Liver Tumors
Metastatic Liver Tumors
Not all liver tumors cancerous?
Noncancerous (benign) tumors are quite common and usually do not produce symptoms. Often, they are not diagnosed until an ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) scan is performed. There are several types of benign liver tumors, including the following:
This benign tumor occurs most often in women of childbearing age. Most of these tumors remain undetected. Sometimes, an adenoma will rupture and bleed into the abdominal cavity, requiring surgery. Adenomas rarely become cancerous.
This type of benign tumor is a mass of abnormal blood vessels. Up to five percent of adults have small liver hemangiomas that cause no symptoms. Treatment is usually not required. Sometimes, infants with large liver hemangiomas require surgery to prevent clotting and heart failure.
angiosarcoma - a rare cancer that originates in the blood vessels of the liver.
cholangiocarcinoma - a cancer that originates in the lining of the bile channels in the liver or in the bile ducts.
fibrolamellar - a variant of hepatocellular carcinoma that usually occurs in young patients between ages 20 to 40.
hepatoblastoma - a common cancer in infants and children, sometimes causing the release of hormones that result in early puberty.
hepatocellular carcinoma - primary liver cancer
Cancer that starts in the liver is called primary liver cancer, or hepatocellular cancer. It is relatively uncommon in the United States, but very common in other parts of the world. Approximately 20,000 cases of primary liver cancer are diagnosed in the United Sates each year and have been steadily increasing in incidence.
Primary liver cancer occurs when cancerous tumors grow within the liver tissue or in the bile ducts within the liver. Although liver cancer is a serious disease that is often diagnosed late in its course, advances in treatments in the past several years have given many patients an improved outlook.
Localized resectable: Cancer is found in one place in the liver and can be totally removed in an operation.
Localized unresectable: Cancer is found only in one part of the liver, but the cancer cannot be totally removed.
Advanced: Cancer has spread through much of the liver or to other parts of the body.
Recurrent: Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the liver or in another part of the body.
When cancer has spread to the liver from other cancers it is called liver metastases. This means that cancerous tumors have spread to the liver from somewhere else in the body. Some of these cancer types or other areas of the body may include:
The risk of cancer spreading to the liver depends on the site of the original cancer. Liver metastasis may be present when the original (primary) cancer is diagnosed, or it may occur months or even years after the primary tumor is removed.
In many cases, there are no symptoms. When symptoms do occur, they may include loss of appetite, confusion, fevers, jaundice, nausea, pain in the upper right part of the abdomen or referred pain to the shoulder blade, sweats, and weight loss. A number of different tests may be necessary for the diagnosis of liver metastases. Some of these tests may be a CT scan of the abdomen, liver function tests, MRI of the abdomen, PET scan, or ultrasound of the liver.
Treatment for liver tumors that have spread from other cancers depends on a number of factors such as the primary cancer site, the number of tumors in your liver, the size of the tumors, location of tumors within the liver, whether or not the cancer has spread to other organs besides your liver, and your overall health. When deciding on treatment, it is important to have a multidisciplinary team evaluate your condition and provide input. A number of treatment options exist and it is crucial to develop an algorithim of treatment as you beat liver tumors. You will want a surgeon to evaluate the possibility of a liver resection or transplant (for primary liver cancer or neuroendocrine cancers), an oncologist to discuss systemic treatments, a radiologist and an interventional radiologist who can discuss targeted liver directed therapies.
When liver tumors progress, complicatons can occur. These complications may include blockage of the flow of bile, decreased appetite, fever, liver failure, pain, and weight loss.
A diagnosis of liver tumors, whether primary or metastatic, is extremely frightening. Gaining knowledge about your own disease status helps empower you and your family members as you approach treatment. You are your own best advocate!!
Lewis RL. Liver and biliary tract tumors. In Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 206.
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