Liver Cancer (Hepatocellular Carcinoma): Or something else? Differential Diagnosis

Liver, gallbladder, and bile ducts-pancreas (pancreas) (K70-K77; K80-K87).

Neoplasms – tumor diseases (C00-D48).

  • Benign (benign) tumors of the liver:
    • (Cavernous) hepatic hemangioma (most common benign tumor of the liver; it is a vascular malformation in the liver) [usually uncomplicated course].
    • Focal nodular hyperplasia (FNH; “benign proliferation of the liver”) [usually uncomplicated course].
    • Hepatocellular adenoma (HCA; benign neoplasm of the liver; occurs mainly in women of childbearing age and is associated with the use of hormonal contraceptives (contraceptives), for example, the birth control pill)[if size ≥ 5 cm:
      • Increase in complications (spontaneous rupture and bleeding (- 30% of cases).
      • Risk of malignant transformation into hepatocellular carcinoma (HCC); this is dependent on sex, growth behavior, and histological/molecular subtype (β-HCA).

      Measures:

      • Women: Discontinuation of oral contraception and weight loss and follow-up.
      • Men: resection due toincreased risk of degeneration.
    • Acquired liver cysts, abscesses (encapsulated accumulation of pus) and hematomas (bruising).
  • Cholangiocellular carcinoma (CCC) – epithelial neoplasia (neoplasm) spreading from the bile ducts; incidence (frequency of new cases): 2-4/100,000/year; second most common primary liver tumor after hepatocellular carcinoma; unfavorable prognosis due to anatomic location and early lymphatic and extrahepatic metastasis (formation of daughter tumors).
  • Hepatoblastoma (HB); most common malignant (malignant) liver tumor in childhood; highest incidence in the first three years of life.
  • Liver metastases (daughter tumors of malignant tumors in the liver); most commonly originate from primary tumors of the gastrointestinal tract; the most common primary tumor is colorectal carcinoma (colorectal cancer): 50% of these patients develop synchronous or metachronous liver metastases during the course of the disease
  • Secondary liver tumors: Neuroendocrine tumors (NET); incidence: 5.3/100,000/year.