Several different kinds of malignant liver tumour are known. The cause of a liver tumour is often a chronic liver disease. Two of these are liver cancer (hepatocellular carcinoma, HCC) and bile duct cancer (cholangiocarcinoma, CCC). Another cause of a liver tumour is metastasis of another tumour, for example bowel or breast cancer.
Patients who have had prior chronic liver disease that has progressed to cirrhosis are more susceptible to tumours. Chronic hepatitis B or C also raise the risk of liver cancer.
It can take years or decades for liver cancer to develop from chronic liver disease - and it does not happen in every case. The speed at which a tumour grows once it has formed is unpredictable. Liver cancer leads to death within months or a few years if treatment is not possible.
Apart from a possible yellowing of the skin and/or the whites of the eyes, nausea and faintness, there may be no symptoms. For this reason, patients with chronic liver disease should undergo regular ultrasound scans and their AFP level monitored, as both can detect a tumour.
In an ideal scenario, a tumour is removed surgically or by ablation. In certain cases a liver can be transplanted. Both of these strategies can bring about a cure. If there is no possibility of transplantation, an attempt is made to combat the tumour tissue by means of superheating, icing, irradiation or targeted injection of chemotherapeutic agents or alcohol solution. Various drugs can be used in primary hepatocellular carcinoma such as immuno-oncologic agents (e.g., atezolizumab, nivolumab, pembrolizumab) and kinase inhibitors such as sorafenib, lenvatinib, regorafenib, and cabozantinib. Sequences and combinations are being study intensively.