Malignant Liver Tumors

Liver cancer or malignant liver tumors can either be primary, meaning the liver cancer or tumor originated in the liver, or metastatic, where the cancer started in an organ other than the liver and spread (metastasized).

Hepatocellular Carcinoma

There are two types of primary liver tumors or cancers. The first and more common of the two is hepatocellular carcinoma (HCC). HCC is most commonly caused by cirrhosis of the liver. Alcoholism and hepatitis C are the two most common causes of cirrhosis in the U.S. Obesity, anabolic steroid abuse, exposure to certain chemicals, and Hepatitis B have also been linked to hepatocellular carcinoma.

Because it often doesn’t cause symptoms in its early stages hepatocellular carcinoma often goes undetected until in its advanced stages. When HCC symptoms are present, they include weight loss, nausea, pain on the upper right side of the abdomen, a feeling of fullness after eating a small amount, and jaundice (yellowing of the eyes and skin). HCC treatment options depend on the stage of the liver cancer and may include: liver resection, in which the tumor is surgically removed; radiofrequency ablation, in which microwaves are used to kill the tumor; radiation; and chemotherapy. A team of physicians works with our patients to decide which HCC treatment option will be best for him or her.

Cholangiocarcinoma

Cholangiocarcinoma, or bile duct cancer, is a fast-moving and often lethal form of cancer. It is a relatively rare, but aggressive tumor that grows from the bile ducts of the liver. There are only approximately 5,000 new cases of cholangiocarcinoma each a year and it is a difficult cancer to cure. The preferred cholangiocarcinoma treatment is surgical resection of the liver or liver transplantation. Cholangiocarcinoma treatment options are determined based on how advanced the cancer is. For bile duct cancer patients that are not surgical candidates, cholangiocarcinoma can be managed, though not cured, with adjuvant therapies like chemotherapy and radiation.

Liver Transplant - Cholangiocarcinoma Treatment
Emory is the only transplant center in Georgia that performs liver transplants for cholangiocarcinoma and one of only two centers performing this protocol in the Southeast, with excellent results. What sets the transplant center at Emory apart is our world-renowned multidisciplinary approach to treating cholangiocarcinoma, which involves not only traditional treatments such as radiation and chemotherapy, but also liver transplantation for appropriate patients. Radiation oncology, medical oncology, hepatology and transplant surgery are just some of the specialties represented by our multidisciplinary physician team. Using liver transplant as a treatment for bile duct cancer has revolutionized the way this team is able to treat cholangiocarcinoma, and offers hope to patients and a chance of long-term survival that cannot be offered with any other treatment.

Metastatic Liver Tumors

Most of the time, malignant tumors in the liver started elsewhere in the body and metastasized (spread) to the liver. Metastatic liver cancer usually originates in another organ, such as the stomach, pancreas, lungs, breasts, or large intestine. Early on, symptoms of metastatic liver cancer can include fever, loss of appetite, and weight loss. Later in the cancer’s progression, symptoms include jaundice and the retention of fluid in the abdomen (a condition called ascites). Blood and imaging tests are used to diagnose metastatic liver cancer. If the results of these tests are unclear, a biopsy of the liver may be necessary.

Once a cancer has metastasized, treatment options are limited. If the tumor or tumors are small enough, they may be removed surgically (resection). Chemotherapy may also be used to shrink liver tumors, though it cannot cure the cancer completely. Other treatment options include radiofrequency ablation, in which microwaves are used to kill the tumor, and embolization, in which the tumor's blood supply is cut off to "starve" the tumor.

Pediatric Hepatoblastoma

Hepatoblastoma is the most common type of liver cancer in children. It usually affects children under the age of 3 and is more prevalent in children who were born premature. The cause of hepatoblastoma is unknown. Most children with hepatoblastoma exhibit no symptoms, and in 40 percent of patients, the disease is advanced at diagnosis. In 20 percent of patients, the cancer has metastasized (spread) to the lungs by the time of diagnosis.

However, advances in diagnosis and treatment in recent years have led to greatly improved prognoses in children with hepatoblastoma. Hepatoblastoma treatment depends on the tumor’s size and whether it has metastasized, but generally involves surgical removal of the tumor and adjuvant treatment (chemotherapy and/or radiation). Inoperable tumors will be treated with adjuvant therapy alone. In rare cases, the child may be considered for a liver transplant.