Hepatocytes are the specialized epithelial cells that chiefly comprise the liver and perform an array of metabolic, endocrine, and secretory functions. Hepatocellular carcinoma is a form of cancer that originates in hepatocytes.

In the United States, hepatocellular carcinoma is relatively rare, but globally it is one of the leading causes of cancer-related death. The disease is especially common in some areas of Africa and Asia, a fact that is widely attributed to the prevalence of the hepatitis B virus in those regions. Studies indicate that individuals with hepatitis B or hepatitis C are at increased risk of developing hepatocellular carcinoma.

In addition to certain hepatitis viruses, hepatocellular carcinoma is commonly linked to cirrhosis of the liver. The malignant tumors of the liver are also, in some cases, attributable to exposure to aflatoxins, a group of toxic compounds produced by various molds. These molds tend to invade stored food supplies, such as peanuts, grains, and beans. In the United States, aflatoxins have been almost completely eliminated, but in some other countries, they are quite prevalent.

The symptoms of hepatocellular carcinoma most commonly include the yellowing of the skin and eyes known as jaundice, an enlarged, often painful or tender abdomen, and easy bruising and bleeding of the skin. Such symptoms can also, however, be indicative of a number of other conditions and, therefore, many other signs are used by physicians to develop a diagnosis. An elevation of serum alpha-fetoprotein levels or liver enzymes, for instance, is often associated with liver cancer, and diagnostic imaging techniques, including ultrasonography, computed tomography, and magnetic resonance imaging, can be used to demonstrate the presence of a liver mass. Findings from testing and imaging are generally either confirmed or refuted by biopsy.

The prognosis of patients with hepatocellular carcinoma is overall relatively poor, though some tumors may be much more successfully treated than others. If the tumor is small or slow growing, surgical removal is often the preferred treatment, but the risk of surgery is too high for some individuals, especially those that have cirrhosis. Surgery can also be problematic because hepatocellular carcinoma is frequently a multifocal tumor and daughter nodules may be overlooked by the surgeon, resulting in rapid recurrence of the disease. Only in about 10 to 20 percent of patients can hepatocellular carcinomas be completely removed utilizing surgical techniques.

Hepatocellular Carcinoma at 10x Magnification - Approximately 3 to 5 percent of the population with cirrhosis of the liver is diagnosed with hepatocellular carcinoma each year, and about 80 percent of all people with hepatocellular carcinoma are cirrhotic.

Hepatocellular Carcinoma at 20x Magnification - Although the specific link between hepatitis viruses and liver cancer is not yet fully understood, some scientists have suggested that viral infection interferes with signal transduction and disrupts the controlled growth of cells.

Hepatocellular Carcinoma at 10x Magnification - Hepatocellular carcinoma patients that are considered poorly suited for surgery may elect to undergo any of several other treatments, including chemotherapy, radiation therapy, percutaneous ethanol injection, transplantation, and transcatheter arterial chemoembolization of the liver.