Liver Cancer
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Liver cancer can be defined as an abnormal, excessive, uncoordinated, autonomous and
purposeless clonal proliferation of cells in the liver. These cancerous cells have the
tendency to spread and grow (metastasise) in other parts of the body.
Primary cancers of the liver include:
● Hepatocellular carcinoma which arises
from the liver parenchymal cells
● Cholangiocarcinoma which arises from the
bile ducts
● Angiosarcoma which arises from vascular
tissue of the liver
● Hepatoblastoma which arises from one or
more of the three primary embryonic germ
layers
Hepatocellular carcinoma is the most common
primary liver cancer comprising about 90% of
all primary cancers of the liver.
Source: https://jyotishsurfer.files.wordpress.com/2018/04/c376a-liverandstomachimage.jpg

Hepatocellular carcinoma is more common in males as compared to females. Incidence of
the hepatocellular carcinoma is higher in Asia and Africa. Hepatocellular carcinoma may
present as a solitary mass or multiple scattered nodules in the liver. A bruit can be heard
while auscultating over the liver area because the hepatocellular carcinoma is a highly
vascular tumor. Sometimes, the hepatocellular carcinoma presents with a massive
intraperitoneal haemorrhage. There may be portal or hepatic vein thrombosis leading to
ascites. Systemic manifestations such as hypoglycaemia and hypercalcaemia may occur. In
most of the cases, serum alpha-fetoprotein (AFP) the level is raised. Hepatocellular
carcinoma is usually detected in advanced stages of the disease.
Source: http://dyhpoon.com/wp-content/uploads/2019/10/normal-liver-cirrhotic-liver-cancer.png

Symptoms of Liver Cancer
Liver cancer is usually asymptomatic during early stages. Liver cancer can lead to high
pressure in blood vessels that feed into the liver. This can cause veins in the esophagus
and stomach to swell with significant risk of bleeding and vomiting blood. Jaundice is the
most common symptom of hepatocellular carcinoma. Other symptoms include:
● Abdominal distension
● Weakness
● Cachexia
● Loss of appetite leading to
weight loss
● Feeling full after a small meal
● Pain or swelling, especially in
the upper-right abdomen
● A yellow tint in the skin and
eyes
● Liver enlargement or a mass
in the area of the liver
● Low blood sugar

Risk factors of developing primary liver cancer
● Studies have shown that carriers of hepatitis B and hepatitis C viruses have hundred
times higher risk of hepatocellular carcinoma. People who never completely recover
from infection with either the hepatitis B or C viruses have persistent inflammation in
the liver
● Cirrhosis which is the scarring of liver cells (hereditary or alcoholic) is another major
risk factor. A sudden deterioration of condition in the patient suffering from liver
cirrhosis should always be suspected of hepatocellular carcinoma
● The food containing aflatoxins, nitrogenous compounds and arsenic may lead to
genesis of the hepatocellular carcinoma
● Smoking and chewing tobacco can cause other cancers which can spread to the
liver

Staging of the Hepatocellular Carcinoma is done as follows:
● In the localised resectable stage of hepatocellular carcinoma, the tumour is confined to
a portion of the liver and its complete surgical resection is possible
● In the localised unresectable stage, the tumour is localised in the liver but its complete
surgical resection is not possible
● In the advanced stage, the hepatocellular carcinoma affects a major portion of the liver
and metastasises to distant parts of the body
● Recurrent hepatocellular carcinoma is the one that reappears after an apparent
recovery by the initial treatment
Procedures used in the diagnosis and evaluation of the hepatocellular carcinoma include
ultrasound, CT scan, estimation of serum AFP, angiography, bone scan, laparoscopy, and
biopsy.

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