Liver Tumors

What Is a Liver Tumor?

A liver tumor develops when liver cells grow abnormally and uncontrollably, forming an abnormal mass of tissue.

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Types of Liver Tumors

1. Benign Tumors

Common benign liver tumors include:

  • Hemangioma.
  • Hepatic adenoma.
  • Focal nodular hyperplasia (FNH).

2. Malignant Tumors (Liver Cancer)

A. Primary Liver Cancer

These cancers begin in the liver itself, including:

  • Hepatocellular carcinoma (HCC).
  • Cholangiocarcinoma.

B. Tumors in Children

  • Hepatoblastoma

C. Metastatic Liver Tumors

These are cancers that begin in another part of the body and spread to the liver. Common primary sites include:

  • Colon.
  • Rectum.
  • Pancreas.
  • Gallbladder.
  • Breast.
  • Lung.
  • Melanoma.

Causes and Risk Factors for Liver Tumors

Risk factors include:

1. Cirrhosis from any cause (liver cirrhosis).

2. Chronic viral hepatitis, particularly hepatitis B, C, and D.

3. Cirrhosis related to NASH and advanced fatty liver disease (NASH cirrhosis).

4. Alcohol-related hepatitis and liver disease (alcoholic hepatitis/cirrhosis).

5. Long-term use of certain hormonal medications, including some birth-control pills (contraceptive pill/hormone).

6. Anabolic steroid use and exposure to arsenic.

7. Aflatoxin, a toxin produced by certain molds that can contaminate foods such as nuts, corn, and other improperly stored foods.

Diagnosis of Liver Tumors

  • Blood Test: Alpha-fetoprotein (AFP).
  • Viral markers: Hepatitis B, Hepatitis C, Hepatitis D and Anti-HBc total
  • Other liver function tests.
  • Abdominal ultrasound.
  • CT scan.
  • CT angiography.
  • MRI.
  • FNAC (fine-needle aspiration cytology) or biopsy when appropriate.
  • Diagnostic laparoscopy in selected cases.

Treatment of Liver Tumors

  • Liver Resection: Part of the liver containing the tumor may be surgically removed. There are different types of liver resection that may be performed, including:
    • Right hepatectomy.
    • Left hepatectomy.
    • Bisegmentectomy.
    • Trisegmentectomy.
    • Extended right hepatectomy.
    • Extended left hepatectomy.
  • Liver Transplantation: In selected patients, the diseased liver containing the tumor is completely removed and replaced with part or all of a donor liver.
  • Liver Cancer Ablation: When surgery cannot provide a curative treatment, certain procedures may be used to destroy or control tumor cells and slow the growth of the cancer.
    • Radiofrequency Ablation (RFA) – Cancer cells are destroyed by applying excessive heat (heat coagulation) through an electrical process (alternating current).
    • Transarterial Chemoembolization (TACE) – A catheter is inserted into the blood vessels supplying the liver tumor. Cancer-fighting medicine is delivered directly to the tumor, along with material that reduces its blood supply.
  • Ethanol Injection: Alcohol (ethanol) is injected directly into the tumor to destroy cancer cells.
  • Medicines for Liver Cancer (Targeted Therapy): Systemic medicines may be used for certain liver cancers, including: Lenvatinib and Sorafenib.
  • Immunotherapy: Some liver cancers may be treated with immunotherapy medicines such as: Nivolumab and Pembrolizumab.

Prevention of Liver Tumors

  • Take comprehensive measures to prevent hepatitis B and C.
  • People with hepatitis B or C should receive appropriate medical treatment and follow-up.
  • Avoid alcohol completely, particularly if you have liver disease.
  • Prevent and manage NASH and fatty liver disease by controlling diabetes, dyslipidemia, hypothyroidism, and excess body weight.
  • Avoid unnecessary long-term use of hormonal medicines (contraceptive pills) and anabolic steroids.
  • Avoid foods that are visibly moldy or improperly stored and may contain aflatoxin.
  • Do not smoke.

Conclusion

  • People with cirrhosis, chronic hepatitis B or C, alcohol-related liver disease, or advanced fatty liver disease (NASH) should undergo an abdominal ultrasound every six months and remain under regular follow-up.
  • Blood tests, including liver function tests and AFP/PIVKA-II when appropriate, may also be used as part of monitoring so that if a liver tumor develops, it can be detected at an early stage and the appropriate treatment can be administered in a timely manner.