Like other cancers, there are different types of liver cancer. The type you have may determine treatments and other important decisions you’ll make with your doctors. If you or a loved one are facing a liver cancer diagnosis, understanding the type you have can help you make informed decisions about your care. Our experts at the OSUCCC – James will help you understand the type of liver cancer you have and what it means.
Hepatocellular carcinoma (HCC)
There are several types of liver cancer. The most common type is hepatocellular carcinoma (HCC). This type of liver cancer accounts for about 80% of all diagnoses and arises from the cells within the liver itself called hepatocytes. This cancer can start as a small tumor that grows over time, or it can begin as many small tumors distributed throughout the liver. Hepatocellular carcinoma is seen more often in the United States and in people with chronic liver damage (cirrhosis).
Rare types of liver cancer
There are other types that are rare. They include:
Cholangiocarcinoma (bile duct cancer)
This form of cancer begins in the cells lining the bile duct tubes that carry bile to the gallbladder. Bile is a fluid made by the liver. Bile is stored in the gallbladder and this substance plays an important role in digestion. The bile ducts connect both the gallbladder and liver to the small intestine. There are subtypes of bile duct cancer, and those are determined based on where the cancer originates. Intrahepatic cholangiocarcinoma is contained within the liver itself. Hilar cholangiocarcinoma forms at the main intersection of the common hepatic duct as it exits the liver. Extrahepatic cholangiocarcinoma forms along the bile ducts outside of the liver along the gallbladder and near the pancreas. There are some similarities between more generalized liver cancer and bile duct cancer, but treatments will vary depending on the type and stage of cancer.
Fibrolamellar carcinoma (FLC)
Fibrolamellar carcinoma, or FLC, is a rare subtype of hepatocellular carcinoma. Fibrolamellar carcinoma mainly affects teenagers and younger adults under 40. For other types of liver cancer, conditions like cirrhosis or hepatitis infections can put a person at risk for developing liver cancer. This cancer, however, unusually forms in people with healthy livers. FLC accounts for less than 1% of all liver cancers in the United States. This cancer may also be called fibrolamellar hepatocellular carcinoma (FLHCC). This rare cancer is often treated with a combination of chemotherapy and surgery.
Hepatoblastoma
While liver cancer is rare in children, hepatoblastoma is the most common pediatric type. It mostly affects children under three years old. Diagnoses of hepatoblastoma in the United States have more than doubled over the last several decades. Research has not been able to determine an exact cause for this increase. There are specific syndromes (symptom clusters) and conditions that are thought to increase the likelihood a child may develop hepatoblastoma. However, research has advanced treatment options and increased the overall cure rate. Diagnostics can help determine appropriate treatments.
Hepatic angiosarcoma
This type of liver cancer is incredibly rare but is the third-most-diagnosed type of liver cancer among adults. It’s a type of soft tissue sarcoma. This aggressive cancer forms in the lining of the blood vessels and lymph vessels within the liver. Hepatic angiosarcoma tends to mostly affect males assigned at birth over the age of 60. The preferred treatment option is surgical removal (resection) of the cancer and some surrounding tissue.
Secondary liver cancer
Cancer that has started in the liver cells or bile ducts themselves is considered primary. A secondary liver cancer, however, is a tumor that begins in another part of the body, such as the colon, lungs or pancreas and then spreads to the liver. When cancer starts in one part of the body and spreads to other parts (such as the liver), it’s called metastasis.
The most common types of cancers that can spread to the liver include colon, lung, breast, stomach, pancreas and kidney. Treatment for cancer that has spread depends on several factors. Experts at the OSUCCC – James will determine the best treatment options for cancer that has spread to the liver.
Benign liver tumors
Not all masses in the tumor are cancer. Frequently, spots in the liver are benign, meaning they aren’t harmful and can’t spread. The main types of benign liver tumors include hemangioma, focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA).
- Hemangiomas are collections of blood vessels that form a mass and may grow over time. Typically, these have no symptoms. Most of these don’t require any treatment. However, in select situations, treatment may include ablation, embolization and surgery. Ablation is a type of procedure that can sometimes be performed outpatient. Embolization therapy is nonsurgical. Hemangiomas are the most frequently diagnosed type of benign liver tumors.
- Focal nodular hyperplasia (FNH) is the second most common type of benign liver tumor. It’s more frequently diagnosed in females assigned at birth, usually over the age of 30. FNH does not become cancerous and most people with these spots do not have any problems. While usually, FNH spots don’t change over time, sometimes they may slowly grow. Typically, FNH does not require treatment.
- Hepatocellular adenomas (HCA) are benign liver growths thought to be linked with hormones. Because of this, they occasionally appear or grow with the use of birth control pills (oral contraceptives) or anabolic steroids for muscle enhancement. Hepatocellular adenomas are typically harmless; however, as they reach a certain size, there are rare cases where they can change to become cancer or rupture, which can lead to bleeding. Males assigned at birth and females assigned at birth tend to have different types of hepatocellular adenoma. The treatment of hepatocellular adenoma in males is usually surgery. In females, the treatment for hepatocellular adenoma depends on the size of the tumor.
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