HEPATOMA (Malignant Liver Tumor; Hepatocellular

General Information

DEFINITION--A malignant tumor that begins in the liver (primary), as opposed to cancer that has spread from another site. Hepatoma is usually associated with an underlying liver disease such as cirrhosis of the liver.

BODY PARTS INVOLVED--Liver.

SEX OR AGE MOST AFFECTED--Adults of both sexes, but more common in men.

SIGNS & SYMPTOMS

• Hard mass in the right upper abdomen.
• Unexplained weight loss and appetite loss.
• Jaundice (yellow skin and eyes; rare).
• Abdominal discomfort that resembles a pulled muscle.
• Low blood sugar (weakness, sweating, hunger, tremor and headache).
• Fever.
• Fluid in the abdomen; enlarged spleen.
• Bleeding tendency in the gastrointestinal tract and other sites.

CAUSES

• Pre-existing cirrhosis of the liver. 50% of persons with hepatoma have cirrhosis.
• Possible slow virus.
• Hepatitis type B or type C infection.

RISK INCREASES WITH

• Medical history of hepatitis; alcoholism.
• Birth control pills.
• Anabolic steroids used by some athletes to build muscles.
• Geographic locations. This is especially common in South Africa and Southeast Asia.

> Don't drink more than 1 or 2 alcoholic drinks--if any--

a day.

• Immunization against hepatitis B may be helpful.
• Regular screening laboratory tests in high-risk individuals (those with cirrhosis or chronic active hepatitis).

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies of liver function and hepatitis B antigen.
• CT scan (See Glossary) of the liver, and ultrasound.
• X-rays of the abdomen, including angiography (See Glossary) of liver blood vessels.
• Liver biopsy (See Glossary).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Surgery to remove the tumor, if possible. Only 25% can be removed successfully. Liver transplantation has been successful in a few patients (see Liver Transplantation in Surgery section).
• Psychotherapy or counseling to help in coping with incurable illness.

POSSIBLE COMPLICATIONS

• Liver failure.
• Spread (metastases) to other organs, especially the lungs, adrenal glands and bones.

PROBABLE OUTCOME--This condition is currently considered incurable. Only a small number of patients survive 5 years following surgery. However, symptoms can be relieved or controlled, and medical literature cites a few instances of unexplained recovery. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES--

• The more you can learn and understand about this disorder, the more you will be able to make informed decisions about where to go for your care, the treatments available, the risks involved, side effects of therapy and expected outcome.
• See Resources for Additional Information.

MEDICATION--

• For minor discomfort, you may use non-prescription drugs such as acetaminophen. Your doctor may prescribe pain relievers, if necessary.
• Anticancer drugs have produced disappointing results so far.

ACTIVITY--Stay as active as your strength allows.

DIET--No special diet. Don't drink alcohol.

Call Your Doctor If

• You have symptoms of hepatoma.
• You develop signs of bleeding, especially from the gastrointestinal tract. Signs include bloody vomit or vomit that contains black material resembling coffee grounds, blood in the stool or black, tarry stools.