Section 10. Liver and Gallbladder Disorders

Chapter 139. Liver Tumors

Topics: Introduction | Hemangioma | Hepatocellular Adenoma | Hepatoma | Other Primary Liver Cancers | Metastatic Liver Cancer

Other Primary Liver Cancers

A cholangiocarcinoma is a relatively slow-growing cancer that originates in the lining of the bile channels in the liver or bile ducts outside the liver. In China, infestation with liver flukes (a type of parasite) may be partly responsible for this cancer. People with long-standing ulcerative colitis and sclerosing cholangitis occasionally develop cholangiocarcinoma. Symptoms of the cancer are often vague but may include sudden deterioration of the person's general health, with jaundice (a yellowish discoloration of the skin and the whites of the eyes), weight loss, and abdominal discomfort.

A hepatoblastoma is one of the more common cancers in infants, boys being affected twice as often as girls are. Occasionally, it occurs in older children and may produce hormones called gonadotropins that result in early (precocious) puberty (see Section 23, Chapter 271). No underlying cause is known.

An angiosarcoma is a rare cancer originating in the blood vessels of the liver. An angiosarcoma may be caused by exposure to vinyl chloride in the workplace, such as in the manufacture of polyvinyl chloride (PVC), or by exposure to arsenic. However, in most people, there is no discernible cause.

Diagnosis and Treatment

A hepatoblastoma is usually suspected when a doctor feels a large mass in an infant's upper right abdomen and the infant is in overall failing health. Cholangiocarcinoma within the liver, hepatoblastoma, and angiosarcoma are diagnosed by liver biopsy, in which a sample of liver tissue is removed with a needle for examination under a microscope (see Section 10, Chapter 134). Cholangiocarcinoma of the bile ducts outside the liver is usually diagnosed by special x-ray techniques (endoscopic retrograde cholangiopancreatography [ERCP] or percutaneous transhepatic cholangiography (see Section 10, Chapter 134)) or at surgery. In two thirds of people with this type of cancer, the cancer has already spread to nearby lymph nodes by the time it is detected.

Usually, treatment of these cancers has little value, and most people die within a few months of when the tumor was detected. If the cancer is detected relatively early, however, the tumor may be surgically removed, offering the hope of long-term survival.