Massachusetts General Hospital

Liver Tumors

What is a tumor?

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.

What are noncancerous liver tumors?

Noncancerous (benign) 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.

What are cancerous liver tumors?

Cancerous (malignant) tumors in the liver have either originated in the liver (primary liver cancer) or spread from cancer sites elsewhere in the body (metastatic liver cancer). Most cancerous tumors in the liver are metastatic.

What is hepatoma (primary liver cancer)?

Also called hepatocellular carcinoma, this 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. Other causes include certain chemicals, alcoholism, and chronic liver cirrhosis.

What are the symptoms of a liver hepatoma?

The following are the most common symptoms of a liver hepatoma. However, each individual may experience symptoms differently. Symptoms may include:

• Abdominal pain

• Weight loss

• Nausea

• Vomiting

• Large mass can be felt in upper, right part of abdomen

• Fever

• Jaundice. Yellowing of the skin and eyes.

• Persistent itching

The symptoms of a liver hepatoma may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

How is liver hepatoma diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for a liver hepatoma may include the following:

• 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.

• 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.

Treatment for liver hepatoma

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 surgery may be used to remove cancerous tissue from the liver. However, the tumor must be small and confined.

• Radiation therapy. Radiation therapy uses high-energy rays to kill or shrink cancer cells.

• Chemotherapy. Chemotherapy uses anticancer drugs to kill cancer cells.

• Liver transplantation

What are other types of primary 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.

What are the stages of liver cancer?

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:

What is metastatic liver cancer?

Cancer that starts in another part of the body and spreads to the liver is called metastatic liver cancer. Cancer that has spread from other areas in the body to the liver usually originated in the lung, breast, colon, pancreas, and stomach. Leukemia and other blood cancers sometimes also spread to the liver.

What are the symptoms of metastatic liver cancer?

The following are the most common symptoms of metastatic liver cancer. However, each individual may experience symptoms differently. Symptoms may include:

• Weight loss

• Poor appetite

• Enlarged, hard, and tender liver

• Fever

• Enlarged spleen

• Ascites. Fluid buildup in the abdominal cavity.

• Jaundice. Yellowing of the skin and eyes.

• Confusion

• Drowsiness

The symptoms of metastatic liver cancer may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

How is metastatic liver cancer diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for metastatic liver cancer may include the following:

• 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.

• 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.

Treatment for metastatic liver cancer

Specific treatment for metastatic liver cancer 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, surgery may be used to remove cancerous tissue from the liver. However, the tumor must be small and confined.

• Radiation therapy. Radiation therapy uses high-energy rays to kill or shrink cancer cells.

• Chemotherapy. Chemotherapy uses anticancer drugs to kill cancer cells.