liver cancer, a malignant neoplastic disease of the liver. Primary liver cancer is common in Africa and Southeast Asia. Primary tumors are 6 to 10 times more prevalent in men than in women, develop most often in the sixth decade of life, and are associated with cirrhosis of the liver in 70% of the cases. Other risk factors include hemochromatosis, hepatitis, schistosomiasis, exposure to vinyl chloride or arsenic, and possibly nutritional deficiencies. Alcoholism may be a predisposing factor, but nonalcoholic cirrhosis is a greater risk than alcoholic cirrhosis. Aflatoxins in moldy grain and peanuts appear to be linked to high rates of hepatocellular carcinoma in parts of Africa. Characteristics of liver cancer are abdominal bloating, anorexia, weakness, dull upper abdominal pain, ascites, mild jaundice, and a tender enlarged liver; in some cases tumor nodules are palpable on the liver surface. Diagnostic procedures include radioisotope scan, biopsy, and various laboratory studies of liver function. An elevated level of alkaline phosphatase, increased retention of sulfobromophthalein, and the presence of alpha-fetoprotein in the blood suggest liver cancer. Most primary liver tumors are adenocarcinomas, classified as hepatomas, when derived from hepatic cells, and cholangiomas, if they originate in cells of the bile duct. Systemic chemotherapy may result in temporary tumor regression; it may be administered with a surgically implanted infusion pump. Liver transplantation may also be used to treat eligible individuals. Irradiation is very destructive to liver cells and not very toxic to tumor cells in the liver. See also hepatoma.
