What are the different types of liver cancer?

Cancer is a group of diseases where abnormal or damaged cells grow in an uncontrolled way, multiplying at a faster rate, living longer than normal cells, and spreading to other parts of the body. Cancers are typically named for the location where the cancer originated.

Liver cancers are cancers that began in the liver. The liver is the body’s largest solid organ, located in the abdomen, inside the lower right side of the rib cage. This organ performs hundreds of vital functions.

Liver cancer is less common in the United States compared to many other forms of cancer. However, rates have been increasing in recent decades, and liver cancers are the sixth leading cause of cancer deaths in the U.S.

Hepatocellular carcinoma (HCC) is the most common type

There are different types of liver cancer, but 80 to 90 percent of cases are a type called hepatocellular carcinoma (HCC). HCC begins in hepatocytes, a type of cell that makes up the majority of the liver’s mass.

HCC is prevalent among people with existing liver disease or conditions that affect the liver. This includes individuals with hepatitis B infections, hepatitis C infections, obesity, metabolic dysfunction-associated steatotic liver disease (MASLD, a type of fatty liver disease), and a number of rare and genetic disorders.

Heavy alcohol use also increases the risk of HCC, and the risk increases further when heavy alcohol use is combined with a hepatitis B or C infection. Cigarette smoking also increases the risk of HCC (as well as many other types of cancers).

Bile duct cancer is the second most common type

Next to HCC, the second most common type of liver cancer is intrahepatic cholangiocarcinoma (IHC), which accounts for 10 to 20 percent of all liver cancers. IHC is a type of bile duct cancer that originates in the intrahepatic bile ducts, a network of tubes that carry bile through the liver.

Bile is a fluid produced by the liver (specifically, the hepatocytes mentioned above). Bile helps the body digest fats, absorb fats and vitamins, remove waste and excess cholesterol, neutralize digestive acid as it passes from the stomach to the small intestine, and kill potentially harmful microbes ingested in foods.

There are also extrahepatic bile ducts that carry bile from the liver to the gallbladder and small intestine. Cancers that form in these bile ducts are called extrahepatic bile duct cancers.

IHC shares the same risk factors as HCC, as well as several others. Conditions associated with a higher risk of IHC include parasitic infections of the bile ducts, bile stones, bile duct cysts, primary sclerosing cholangitis (a rare disease that causes narrowing of the bile ducts), and inflammatory bowel disease (IBD).

There are also types that are rare or uncommon

Beyond HCC and IHC, there are several rare types of liver cancer.

• Fibrolamellar hepatocellular A type of liver cancer that mostly affects adolescents and young adults. It is not caused by underlying conditions like hepatitis infections or cirrhosis.
• This is the most common type of liver cancer in children, with most cases occurring before the age of 2 years. Most cases occur without an identifiable cause, but roughly one-third of cases are associated with genetic disorders, chromosome disorders, or other cancers.
• Hepatic angiosarcoma. Cancer that originates in the blood vessels or lymph vessels in the liver. The majority of cases have unknown causes, but roughly one-quarter of cases are associated with exposure to industrial chemicals (vinyl chloride), arsenic, or radium. These cancers are often not diagnosed until advanced stages.

For information about risk, symptoms, prevention, or a diagnosis of liver cancer, a healthcare provider will be your best source of information.