It is important that the lay reader does not confuse the term ‘liver cancer’, when referring to secondary cancer spreading to the liver, with primary cancer of the liver. In the Western world, the occurrence of metastatic cancer in the liver far exceeds the incidence of primary liver cancer and such problems in the liver are treated by the methods used to control the primary cancer. That is to say that if a patient has developed secondary breast cancer in the liver then it is treated with chemotherapy to which breast cancer is sensitive and not as a primary liver cancer would be.
Hepatocellular carcinoma is a true carcinoma but usually an aggressive one with a high mitotic rate (i.e many cells capable of division at any one time). In the most commonly encountered form, the microscopoist can recognise the attempts by the tumour cells to form the trabeculae that are characteristic of normal liver histology – the microtrabecular variant.
Two other forms: the sclerosing variant and the fibrolamellar varant are recognised, the latter tending to occur in younger patients and equally in males and females; it has a relatively better outlook
