Cancerous tumours of the liver

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A cancerous tumour that starts in the cells of the liver is called primary liver cancer. It can grow into nearby tissue and destroy it. The tumour can also spread (metastasize) to other parts of the body. Cancerous tumours are also called malignant tumours.

Hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. It starts in the cells that make up the body of the liver (called hepatocytes).

HCC can develop in different ways. It may develop as a single tumour that can get very large if not detected early, but it does not invade tissues or vessels (called classical HCC).

There are subtypes of HCC called variants. Variants of HCC are named based on how they grow and include:

  • fibrolamellar
  • sclerosing (scirrhous)
  • clear cell
  • sarcomatoid (spindle cell)
  • pleomorphic (giant cell)

Intrahepatic bile duct cancer

The bile ducts are the tubes that carry bile (a yellow-green fluid that helps digest fat) from the liver to the first part of the small intestine (called a duodenum).

When cancer starts in a bile duct inside the liver, it is called intrahepatic bile duct cancer or cholangiocarcinoma. This type of cancer is treated like HCC, usually with surgery.

Find out more about intrahepatic bile duct cancer.

Rare primary liver tumours

The following cancerous tumours can start in the liver, but they are rare:

  • soft tissue sarcomas, including angiosarcoma, leiomyosarcoma, fibrosarcoma, rhabdomyosarcoma and epithelioid hemangioendothelioma
  • neuroendocrine tumours
  • non-Hodgkin lymphoma, usually hepatosplenic T-cell lymphoma
  • hepatoblastoma (usually found in young children and rare in adults)
  • mixed hepatocellular cholangiocarcinoma (a combination of HCC and cholangiocarcinoma)

These tumours are usually treated with surgery. Chemotherapy may be offered to treat tumours that cannot be removed by surgery or to shrink tumours before surgery.

Liver metastasis

In Canada, liver metastasis is much more common than primary liver cancer. Liver metastasis is cancer that started in another part of the body and has spread to the liver. The tumour in the liver is made up of the type of cells where the cancer started, not liver cells. For example, when colon cancer spreads to the liver, the cancer cells in the liver are colon cancer cells. It is metastatic colon cancer, not liver cancer.

Find out more about liver metastases.

Expert review and references

  • Kelly W Burak, MD, FRCPC, MSc(Epid)
  • Vincent Tam, BSc(Hon), MD, FRCPC
  • American Cancer Society. What is Liver Cancer?. 2019. https://www.cancer.org/.
  • American Society of Clinical Oncology (ASCO). Cancer.net: Liver Cancer: Introduction. 2021.
  • Fong Y, Dupuy DE, Feng M, Abou-Alfa G. Cancer of the liver. DeVita VT Jr., Lawrence TS, Rosenberg SA, eds.. DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia, PA: Wolters Kluwer; 2019: 57:844–865.
  • PDQ® Adult Treatment Editorial Board. Adult Primary Liver Cancer Treatment (PDQ­®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2019. https://www.cancer.gov/.
  • Siegel AB, Sheynzon V, & Samstein B. Uncommon hepatobiliary tumors. Raghavan D, Blanke CD, Honson DH, et al. (eds.). Textbook of Uncommon Cancer. 4th ed. Wiley Blackwell; 2012: 6(30):423-440.

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