Liver cancer

Liver cancer or hepatic cancer (from the Greek hēpar, meaning liver) is a cancer that originates in the liver. Liver cancers are malignant tumors that grow on the surface or inside the liver. Liver tumors are discovered on medical imaging equipment (often by accident) or present themselves symptomatically as an abdominal mass, abdominal pain, jaundice, nausea or liver dysfunction. Liver cancers should not be confused with liver metastases, which are cancers that originate from organs elsewhere in the body and migrate to the liver.

Classification
There are many forms of liver cancer, although many cancers found in the liver are metastases from other tumors, frequently of the GI tract (like colon cancer, carcinoid tumors mainly of the appendix, etc.), but also from breast cancer, ovarian cancer, lung cancer, renal cancer, prostate cancer, etc.

The most frequent liver cancer is hepatocellular carcinoma (HCC) (also named hepatoma, which is a misnomer because adenomas are usually benign). This tumor also has a variant type that consists of both HCC and cholangiocarcinoma components. The cells of the bile duct coexist next to the bile ducts that drain the bile produced by the hepatocytes of the liver. Cancers which arise from the blood vessel cells in the liver are known has hemangioendotheliomas.

As well as mixed tumors, rarer forms of liver cancer include: There is not yet a permanent cure for it.
 * mesenchymal tissue
 * Sarcoma
 * Hepatoblastoma, a rare malignant tumor, primarily developing in children. Most of these tumors form in the right lobe.
 * Cholangiocarcinoma (bile duct cancers), which account for 1 or 2 out of every 10 cases of liver cancer. These cancers start in the small tubes (called bile ducts) that carry bile to the intestine.
 * Angiosarcoma and hemangiosarcoma: These are rare forms of cancer that start in the blood vessels of the liver. These tumors grow quickly. Often by the time they are found they are too widespread to be removed. Most patients do not live more than a year after diagnosis.
 * Lymphoma of liver: A rare form of lymphoma that usually have diffuse infiltration to liver. It may also form a liver mass in rare occasions.

Symptoms of cholangiocarcinoma

 * sweating
 * Jaundice
 * Abdominal pain
 * Weight loss
 * Hepatomegaly

Symptoms of hepatocellular carcinoma

 * Abdominal mass
 * Abdominal pain
 * Emesis
 * Anemia
 * Back pain
 * Jaundice
 * Itching
 * Weight loss
 * Fever

Causes

 * A 2009 study suggested that l-carnitine deficiency is a risk factor for liver cancer, and that supplementation with it could reduce the risk.
 * Chronic Hepatitis B infection can lead to liver cancer.
 * Japan being member of International Cancer Genome Consortium is leading efforts to map liver cancer's complete genome.

Management
A PET-CT scan may be suggested if doctors are considering surgery as a treatment. It gives more detailed information about the part of the body being scanned. The correct treatment of liver cancer can mean the difference between life and death. Not all patients with cancers in the liver are potentially curable. These are some of the treatments available: Surgery, Chemotherapy, Immunotherapy, Photodynamic Therapy, Hyperthermia, Radiation Therapy and Radiosurgery.

Treatment of hepatocellular carcinoma

 * Partial hepatectomy to resect all of the tumor.
 * Liver transplantation
 * Cryoablation
 * Chemoembolization
 * Radiotherapy
 * Sorafenib
 * Radiofrequency ablation
 * Radiofrequency ablation combined with local chemotherapy See: http://www.clinicaltrials.gov/ct2/show/NCT00617981?term=Thermodox&rank=3

Treatment of cholangiocarcinoma

 * Photodynamic therapy
 * Brachytherapy
 * Radiotherapy
 * Liver transplantation

Treatment of hepatoblastoma

 * Chemotherapy, including vincristine, cyclophosphamide, and doxorubicin
 * Radiotherapy
 * Liver transplantation
 * Surgical resection

Epidemiology
Liver cancer as a cause of death is reported at less than 30 cases per 100,000 inhabitants in most of the world, with higher rates observed in parts of Africa and eastern Asia.