Liver Tumors

Tumors found in the liver can be benign (non-cancerous) or malignant (cancerous). Some of the benign tumors can be left untreated, but sometimes they must be removed. Primary liver cancer (cancer that originates in the liver) is not as common in the United States as it is in other parts of the world, but there are still about 16,000 cases diagnosed in America each year. Most of the time, liver cancer begins in another organ and spreads to the liver. These tumors are called secondary liver tumors or metastases. Liver cancer usually is not diagnosed until it has reached an advanced stage, when removing a tumor surgically is less often a possible treatment choice.

Primary liver cancer or hepatoma (Hepatocellular Cancer-HCC). While HCC is relatively rare in the United States, it is becoming more common as an unwanted consequence of the hepatitis C epidemic. About 80 percent of the time, HCC occurs in people who have cirrhosis, which can be the result of chronic hepatitis B or C, alpha-1-antitrypsin deficiency, or alcoholic or nonalcoholic fatty liver disease.

Cancer that begins in another part of the body and then spreads to the liver is by far the most common form of liver cancer. The usual cancers that spread to the liver originate in the colon (large intestine), breast and lung. Usually liver metastases do not cause symptoms in their early stages and when symptoms such as jaundice or pain do occur, it is often too late. That’s why it is important that patients with treated cancers have regular follow ups to discover any reoccurrence or spread of their tumors to the liver or other organs.

A hemangioma is a cluster of tiny blood vessels that form a non- cancerous tumor. A hepatic hemangioma is a common, benign tumor found in the liver, occurring more frequently in women than in men. They are often found when patients undergo ultrasound or CT scans for other problems. Most of the time, hepatic hemangiomas do not cause any problems and do not require treatment. When they do, it often is because of their size and/or their proximity to other organs. Large hepatic hemangiomas can cause pain or enlargement of the liver, and in rare cases, they can rupture. In those instances when the tumor is causing problems or thought to be in a troublesome location, surgical removal is indicated. In most instances surgeons are able to peel out the hemangioma without removing much of the normal liver.

A hepatic adenoma is an uncommon, benign tumor that on rare occasion becomes a malignant hepatocellular carcinoma. Adenomas usually do not have any symptoms but are more likely to rupture than any of the liver tumors and therefore patients with these tumors need to seek medical advice. The long-term use of oral contraceptives is associated with the development of adenomas, and sometimes if a woman stops using that form of birth control, the adenoma may shrink. If the tumors do not shrink quickly surgical removal is indicated.

With this type of benign tumor, a nodule (often containing central scar tissue) grows in the liver. An FNH tumor usually does not present any symptoms, but if it is unusually large or causing pain, surgical removal often is recommended. This is because in rare instances these tumors can rupture; removing the ones that are large and most likely to cause problems can be prudent. They are found more frequently in women than in men, and it is thought that hormones “feed” FNH tumors