Hepatocellular carcinoma

As opposed to benign hepatic tumors, malignant hepatic tumors are cancerous, very severe, and are actually now the third leading cause of cancer deaths worldwide.

With these malignant liver cells or hepatocytes, just like malignant cells in other cancers, they develop some mutation that causes them to replicate at way higher rates and form these masses of cells that continue to grow and potentially spread to other tissues.

This would be a primary hepatic tumor, since it starts in the liver. It’s totally possible, though, for liver tumor to develop as a metastasis from another primary cancer, in which case it would not be hepatocellular carcinoma, but a carcinoma from somewhere else, and this is actually more common than primary liver tumors themselves.

The most common sources of the tumor cells that got to the liver but started somewhere else are the colon, pancreas, lung and breast.

What exactly causes the mutation in the hepatocyte though?

Well the mechanism isn’t fully understood and can probably be caused by a lot of different things, most importantly though, things that put the liver in a constant cycle of damage and repair are the biggest culprits.

If the liver cells are constantly being forced to repair, this raises the chances of genetic mistakes or mutations, potentially leading to carcinogenesis or development of cancer cells.

Examples might be any disease that leads to cirrhosis and scarring of the liver tissue, which can include alcoholic hepatitis and cirrhosis, hereditary hemochromatosis, primary biliary cirrhosis, alpha-1 antitrypsin deficiency, and others.

The most common risk factor, the ones that have been linked the most with hepatocellular carcinoma are the hepatitis B and hepatitis C viruses, both of which can become chronic or long-lasting.

In this case, these cells are at greater risk because of the constant state of infection and immune cell attack, leading to constant damage and repair.

HBV is particularly problematic because of how the virus replicates; the HBV virus is a DNA virus that integrates into the hepatocyte’s DNA, which, although not completely understood, is thought to either directly disrupt regulation of cell growth and replication, leading to carcinoma, or alternatively cause some indirect effect that later leads to unchecked cell growth and replication.