Description
Hepatocellular carcinoma is by far the commonest of liver tumours and most cases are due to chronic HBV or HCV infections; aflatoxin, alcohol and haemochromatosis account for a minority only. Precancerous morphological changes include nodular lesions in cirrhosis and large and small liver cell dysplasia. The pathology is well described and immumocytochemistry helps to differentiate cholangiocarcinoma and metastatic tumours in difficult cases. Cholangiocarcinoma is much less common except in South East Asia where it is related to liver fluke infestation. There are distinctive but rare childhood tumours such as hepatoblastoma and sarcomas, particularly those of vascular origin, that affect adults. Liver cell adenoma is the most important benign tumour of the liver and its close association with oral contraceptive steroids created much anxiety in the recent past but, fortunately, the number of cases has remained small.
