Merck Manual

Please confirm that you are a health care professional

honeypot link

Primary Liver Cancer


Danielle Tholey

, MD, Sidney Kimmel Medical College at Thomas Jefferson University

Last review/revision Aug 2021 | Modified Sep 2022
View Patient Education

Primary liver cancer is usually hepatocellular carcinoma Hepatocellular Carcinoma Hepatocellular carcinoma usually occurs in patients with cirrhosis and is common in areas where infection with hepatitis B and C viruses is prevalent. Symptoms and signs are usually nonspecific... read more . The first manifestations of liver cancer are usually nonspecific, delaying the diagnosis. When diagnosed at advanced stages, prognosis is poor.

Other Primary Liver Cancers

Fibrolamellar carcinoma

This distinct variant of hepatocellular carcinoma has a characteristic morphology of malignant hepatocytes enmeshed in lamellar fibrous tissue. It usually occurs in young adults and has no association with preexisting cirrhosis, hepatitis B virus (HBV), hepatitis C virus (HCV), or other known risk factors. Alpha-fetoprotein (AFP) levels are rarely elevated.



Although rare, hepatoblastoma is one of the most common primary liver cancers in infants, particularly those with a family history of familial adenomatous polyposis Familial Adenomatous Polyposis Familial adenomatous polyposis is a hereditary disorder causing numerous colonic polyps and frequently resulting in colon carcinoma, often by age 40. Patients are usually asymptomatic but may... read more Familial Adenomatous Polyposis . It can also develop in children. Some patients with hepatoblastoma present with precocious puberty caused by ectopic gonadotropin production, but the cancer is usually detected because of deteriorating general health and a right upper quadrant mass. An elevated AFP level and abnormal imaging test Imaging Tests of the Liver and Gallbladder Imaging is essential for accurately diagnosing biliary tract disorders and is important for detecting focal liver lesions (eg, abscess, tumor). It is limited in detecting and diagnosing diffuse... read more Imaging Tests of the Liver and Gallbladder results may help in the diagnosis.


This rare cancer is associated with specific chemical carcinogens, including industrial vinyl chloride.


This rare disorder is probably secondary to malignant transformation of a cystadenoma and is often multilobular.

Treatment is liver resection.


View Patient Education
NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
quiz link

Test your knowledge

Take a Quiz!