Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is the most common primary liver cancer, arising from the liver’s own cells (hepatocytes). It most often develops in people with chronic liver disease, especially cirrhosis, hepatitis B or C infection, or long-term fatty liver disease. Some individuals have no symptoms early on, while others may experience abdominal pain, weight loss, jaundice, or swelling due to liver dysfunction. Imaging is essential for diagnosis, staging, and treatment planning.
What is it?
Hepatocellular carcinoma develops when liver cells undergo changes that cause them to grow uncontrollably and form a tumor. Most cases occur in the setting of chronic liver injury, such as cirrhosis or hepatitis, where repeated inflammation and regeneration increase the risk of abnormal cell changes. HCC may present as a single mass, multiple nodules, or spread throughout the liver. In advanced cases, it can invade blood vessels or spread beyond the liver.
Imaging plays a central role in diagnosing HCC. Characteristic features—such as arterial phase enhancement and delayed washout on CT or MRI—can allow diagnosis without biopsy in many cases. Imaging also evaluates tumor size, number, location, involvement of blood vessels, and suitability for treatments such as resection, transplant, or locoregional therapies (e.g., TACE or ablation).
Important to Know
Early detection of HCC greatly improves treatment options and outcomes. People with cirrhosis or chronic hepatitis often undergo regular screening with ultrasound or MRI to identify tumors at an early stage. Symptoms such as abdominal swelling, jaundice, worsening fatigue, or unintended weight loss should prompt evaluation, especially in individuals with known liver disease.
Red flags include sudden severe abdominal pain, confusion, vomiting blood, or rapid abdominal swelling, as these may indicate liver failure or bleeding. Treatment decisions consider both the cancer stage and the overall function of the liver. Follow-up imaging is essential after treatment to monitor for recurrence or new tumor growth.