Hepatocellular carcinoma-HCC (also called hepatoma) is a primary malignancy of the liver. Most cases of HCC are secondary to either a viral hepatitide infection (hepatitis B or C) or cirrhosis (alcoholism being the most common cause of hepatic cirrhosis). In countries where hepatitis is not endemic, most malignant cancers in the liver are not primary HCC but metastasis (spread) of cancer from elsewhere in the body, e.g. the colon. Treatment options of HCC and prognosis are dependent on many factors but especially on tumor size and staging.

The best method of diagnosis involves a CT scan of the abdomen using intravenous contrast agent and three-phase scanning (before contrast administration, immediately after contrast administration, and again after a delay) to increase the ability of the radiologist to detect small or subtle tumors.

On CT, HCC can have three distinct patterns of growth:

·         A single large tumor

·         Multiple tumors

·         Poorly defined tumor with an infiltrative growth pattern

Mostly the radiologists are using MRIs to do a secondary study to look at an area where a tumor has already been detected.

Among types of treatment:

· Liver transplantation to replace the liver with a cadaver liver or a live donor lobe.   If the tumor disease has metastasized, the immunosuppressant post-transplant drugs decrease the chance of survival.

·  Surgical resection to remove a tumor to treat small or slow-growing tumors if they are diagnosed early. This treatment offers the best prognosis for long-term survival but unfortunately is possible in only 10-15% of cases.

· Transcatheter arterial chemoembolization (TACE) is usually performed in the treatment of large tumors (larger than 3 cm and less than 4 cm in diameter), most frequently by intraarterially injecting an infusion of antineoplastic agents mixed with iodized oil. 

· Hormonal therapy

· Cryosurgery: Cryosurgery is a new technique that can destroy tumors in a variety of sites (brain, breast, kidney, prostate, liver). Cryosurgery is the destruction of abnormal tissue using sub-zero temperatures.

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