Hepatocellular carcinoma accounts for 80% to 90% of all liver cancers. It occurs more often in men than women and occurs mostly in people 50 to 60 years old. The disease is more common in parts of Africa and Asia than in North or South America and Europe.

The cause of liver cancer is usually cirrhosis, or scarring of the liver. Cirrhosis may be caused by viral hepatitis, primarily hepatitis B and C, alcohol abuse, hemochromatosis, certain autoimmune diseases of the liver, and a whole host of other diseases that result in chronic inflammation of the liver leading to scarring. The most common cause for cirrhosis in the U.S. is alcohol abuse.

• Abdominal pain or tenderness, particularly in the right-upper quadrant
• Enlarged abdomen
• Easy bruising or bleeding
• Jaundice (a yellow discoloration of the skin and eyes)

• Physical examination shows an enlarged, tender liver.
• A liver biopsy shows hepatocellular carcinoma.
• Serum alpha fetoprotein may be elevated.
• There may be a mass shown on abdominal CT scan.
• A liver scan may indicate an abnormality.
• Liver enzymes (liver function tests) are elevated.

Aggressive surgery or liver transplantation may be successful in treating small or slow-growing tumors if they are diagnosed early.

Chemotherapy and radiation treatments are not usually effective but may be used to shrink large tumors so that surgery has a greater chance of success.

• Gastrointestinal bleeding
• Liver failure
• Spread (metastasis) of the carcinoma