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Liver cancer types

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.

Hepatocellular carcinoma (HCC)

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 41,630 U.S. adults are expected to be diagnosed with liver cancer in 2024, according to the American Cancer Society.

Hepatocellular carcinoma risk factors

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.

Hepatocellular carcinoma symptoms

HCC may not cause symptoms, particularly in the early stages of the disease. If patients do have symptoms, they may include:

  • Nausea and vomiting
  • A feeling of fullness, even if the patient hasn't eaten
  • Unexplained weight loss
  • Bloating or swelling in the stomach
  • Yellowing of the eyes or skin (jaundice)
  • Stomach pain

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.

Hepatocellular carcinoma treatment

Possible HCC treatments include:

  • Surgery to remove the tumor
  • Liver transplantation
  • Radiation therapy
  • Ablation, which uses targeted heat to destroy cancer cells

Other targeted medications or therapies may also be available, depending on the specifics of the disease.

Fibrolamellar HCC

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.

  • This cancer is most common in women younger than age 35.
  • About 1 percent of all hepatocellular carcinomas are fibrolamellar HCC, according to the American Cancer Society (ACS).

Cholangiocarcinoma

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 types

Cholangiocarcinoma is categorized into two types:

  • Intrahepatic bile duct cancer begins in ducts located in the liver.
  • Extrahepatic bile duct cancer develops in ducts outside the liver.

Cholangiocarcinoma risk factors

Risk factors for bile duct include having a chronic inflammatory condition in the liver, such as:

  • Primary sclerosing cholangitis (PSC)
  • Bile duct stones
  • Cirrhosis
  • Hepatitis B or C infection

Other rare liver diseases and inflammatory bowel disease may increase the risk as well, as may heavy alcohol use, obesity and older age.

Cholangiocarcinoma symptoms

Though they may not present themselves until more advanced stages, possible bile duct cancer symptoms include:

  • Jaundice (yellowing of skin and whites of eyes)
  • Itching
  • Fever
  • Abdominal pain

Cholangiocarcinoma treatment

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.

Cholangiocarcinoma survival rate

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

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).

Angiosarcoma risk factors

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 symptoms

Angiosarcoma in the liver may cause no symptoms or it may feel like a lump in the abdomen.

Angiosarcoma treatment

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.

Metastatic cancer to the liver

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 of metastatic cancer in the liver

Symptoms vary depending on how much of the liver is affected. Possible symptoms include:

  • Fatigue
  • Loss of appetite
  • Jaundice
  • Fever
  • Swelling or pain in the abdomen

Treatment of metastatic cancer in the liver

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.

Hepatoblastoma

Although rare, hepatoblastoma is the most common liver cancer in pediatric patients. It occurs in the lobes of the liver.

Hepatoblastoma risk factors

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 symptoms

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.

Hepatoblastoma treatment

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.

Hepatoblastoma survival rate

The survival rate for hepatoblastoma is between 70 percent to 80 percent, according to a study published in F1000Research.

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