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Liver cancer takes the form of a malignant tumor that grows inside or on the surface of the liver. The liver is a vital organ with several functions. It detoxifies the body, synthesizes protein, and produces the biochemicals needed for digestion. There isn’t any current substitute for long-term absence of liver function. This makes diagnosis and proper treatment of liver cancer a necessity for survival.

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Misdiagnosis of Liver Cancer

Immediate diagnosis and treatment of liver cancer is often the difference between life and death. Liver cancer can metastasize quickly. As time passes, more metastases will be present that make full removal increasingly difficult. As of 2008, liver cancer was recorded as the third leading cause of global cancer deaths. Liver cancer kills roughly 700,000 people a year.

Liver cancer can be mistaken for:

  • Fatty liver
  • Pancreatic cancer
  • Liver abscess
  • Mosse syndrome
  • Hepatic hemangioma
  • Alveolar hydatiddisease

Types of Liver Cancer

The two primary types of liver cancer are hepatocellular carcinoma and cholangiocarcinoma. Often, many cancers found inside the liver are metastases that originated in other parts of the body and migrated to the liver. This is referred to as secondary liver cancer. Common cancers that metastasize to the liver include GI tract cancers, breast cancer, lung cancer, and prostate cancer. There are also several rare forms of liver cancer, including sarcoma, hepatoblastoma, angiosarcoma, and lymphoma.

Hepatocellular Carcinoma (HCC)

HCC is the most common type of liver cancer and one of the world’s most common tumors. Most cases are secondary to a viral hepatitis B or C infection or cirrhosis. Cirrhosis is characterized by irreversible scarring and poor liver function. It is most commonly caused by alcoholism.The outcome is generally poor. Only 10% to 20% of these carcinomas can be fully surgically removed.

Cholangiocarcinoma

This type of liver cancer derives from mutated epithelial cells originating from the ducts that drain the liver’s bile into the small intestine. While it is a less common form of cancer, cases of cholangiocarcinoma are rising worldwide. It is considered incurable and fatal unless the main tumor and all metastases are removed surgically. The five-year survival rate is less than 5%.

Symptoms of Liver Cancer

Symptoms of hepatocellular carcinoma may include:

  • Abdominal pain
  • Abdominal mass
  • Back pain
  • Itching
  • Weight loss
  • Fever
  • Vomiting
  • Anemia, or decrease in red blood cells
  • Jaundice, or yellowing of the skin, eyes, and mucous membranes

Cholangiocarcinoma symptoms may present as:

  • Abdominal pain
  • Sweating
  • Itching
  • Weight loss
  • Fever
  • Jaundice
  • Hepatomegaly, or an enlarged liver

Diagnosis and Treatment

Liver cancer is typically discovered using medical imaging equipment or evidenced through symptoms. Once suspected, blood tests are performed to diagnose and monitor liver cancer. These tests are used to measure levels of certain proteins and enzymes that indicate normal liver functioning. Bilirubin levels are an important indicator of normal functioning. Bilirubin is a byproduct of the liver’s breakdown of old red blood cells.

Other testing for liver cancer may involve:

  • Abdominal ultrasound to see the tumor
  • Liver biopsy to remove liver tissue for examination
  • CT scan or MRI to identify the tumor and pinpoint size and location
  • Endoscopy to see inside the esophagus, stomach, and lower intestine
  • ERCP, a fiberoptic endoscope to insert dye into the bile ducts for X-rays
  • PTC, a thin needle through the skin and bile ducts to insert X-ray dye

Once diagnosed, treatment options for liver cancer include:

  • Liver transplantation
  • Chemotherapy
  • Radiotherapy
  • Immunotherapy
  • Hyperthermia

 

Sources:

El-Serag, Hashem B. “Hepatocellular Carcinoma.”The New England Journal of Medicine. 365.12 (2011): 1118-1127. MEDLINE with Full Text.Web. 28 Nov. 2012.
Hussain, Hero K., and Isaac R. Francis.Primary Carcinomas of The Liver.n.p.: Cambridge University Press, 2010.eBook Collection (EBSCOhost). Web. 28 Nov. 2012.
Phelps, Jerry. “Hepatitis B virus mutation predicts liver cancer.” Environmental Health Perspectives. 112.11 (2004): A619. Academic OneFile.Web. 28 Nov. 2012.