This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science.
This page was updated on March 8, 2023.
The types of liver cancer are based on specifics about the cells that become cancerous.
Every liver cancer patient is different. After diagnosing the disease and determining the patient's liver cancer stage, the care team will develop a treatment plan tailored to the patient’s specific type of liver cancer.
Also called hepatoma, HCC is the most common type of liver cancer, accounting for approximately 75 percent of all liver cancers. HCC starts in the main type of liver cells, called hepatocellular cells. Most cases of HCC are the result of infection with hepatitis B or C, or cirrhosis of the liver caused by alcoholism.
HCC is more common in men than in women, and it's believed to account for about three-fourths of all liver cancer diagnoses. To put that in perspective, about 41,210 U.S. adults are expected to be diagnosed with liver cancer in 2023, according to the American Cancer Society.
Conditions that increase the risk of HCC include hepatitis B or C, cirrhosis (scarring in the liver) and non-alcoholic fatty liver disease. Other factors, such as heavy alcohol use, obesity, tobacco use or diabetes, may also increase risk.
HCC may not cause symptoms, particularly in the early stages of the disease. If patients do have symptoms, they may include:
Hepatocellular carcinoma may develop as a single growing tumor that possibly spreads throughout the liver at more advanced stages, or it shows up as multiple small tumors. The second type is more common and is associated with cirrhosis.
Possible HCC treatments include:
Other targeted medications or therapies may also be available, depending on the specifics of the disease.
Fibrolamellar HCC is a rare type of hepatocellular carcinoma that is typically more responsive to treatment than other types of liver cancer. Fibrolamellar cancer is treated similarly to HCC.
Also known as bile duct cancer, cholangiocarcinoma occurs in the small, tube-like bile ducts within the liver that carry bile to the gallbladder. Cholangiocarcinomas account for 10 percent to 20 percent of all liver cancers, and about 8,000 patients are diagnosed with bile duct cancer each year in the United States, according to the ACS.
Cholangiocarcinoma is categorized into two types:
Risk factors for bile duct include having a chronic inflammatory condition in the liver, such as:
Other rare liver diseases and inflammatory bowel disease may increase the risk as well, as may heavy alcohol use, obesity and older age.
Though they may not present themselves until more advanced stages, possible bile duct cancer symptoms include:
Bile duct cancer treatment is similar to treatment for HCC. The care team will develop a bile duct cancer treatment plan personalized to the patient's cancer type, stage and other factors.
The five-year survival rate for all stages of bile duct cancer developing in the liver (intrahepatic bile duct cancers) is 9 percent, according to the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program database. For those that develop outside the liver (extrahepatic bile duct cancers), the rate is 10 percent.
Angiosarcoma of the liver accounts for about 1 percent of all liver cancers. Angiosarcomas begin in the blood vessels of the liver and grow quickly. They are typically diagnosed at an advanced stage. About one in a million people are estimated to be diagnosed with angiosarcoma each year in the United States, according to the National Cancer Institute (NCI).
Risk factors for angiosarcoma in the liver include exposure to certain environmental chemicals (such as vinyl chloride, arsenic or thorium dioxide) or certain inherited diseases (such as hereditary hemochromatosis).
Angiosarcoma in the liver may cause no symptoms or it may feel like a lump in the abdomen.
When angiosarcoma affects the liver, it's typically very difficult to treat, but chemotherapy or radiation may be used to slow the disease's progression.
Metastasis develops when primary cancer spreads from its original location to another part of the body.
Most metastases that spread to the liver originate from colon or colorectal cancer. More than half of patients diagnosed with colorectal cancer develop cancer in the liver.
Cancer may also spread to the liver from the lung, breast, stomach, pancreas, kidney, esophagus or skin. The liver is one of the most common places for cancer to spread.
Symptoms vary depending on how much of the liver is affected. Possible symptoms include:
Surgery, ablation or radiation therapy may be used to treat cancer that has metastasized (spread) to the liver.
Metastatic cancer is considered part of the patient's primary cancer. For example, if the cancer started in the lungs and then spread to the liver, the cancer would still be treated as lung cancer.
Although rare, hepatoblastoma is the most common liver cancer in pediatric patients. It occurs in the lobes of the liver.
About one-third of hepatoblastoma cases are associated with an inherited disorder, such as Beckwith-Wiedemann syndrome, Edward syndrome, Aicardi syndrome, Down syndrome or other genetic abnormalities.
Hepatoblastoma has been associated with low birth weight, preeclampsia in the mother, or maternal smoking before or during pregnancy.
Hepatoblastoma is usually diagnosed within the first three years of life. The main symptom is a large, painful abdominal mass. Blood chemistry tests or imaging methods, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, may be used to identify a hepatoblastoma.
The most common treatment path starts with neoadjuvant chemotherapy, which means chemotherapy intended to reduce, not completely get rid of, the tumor. After this, the tumor may be removed with surgery in many cases.
The survival rate for hepatoblastoma is between 70 percent to 80 percent, according to a study published in F1000Research.