There are a few very rare cancers that can start in the liver.
Cancer of the gallbladder is rare in the UK, but is the 5th commonest cancer worldwide. Sometimes it’s diagnosed during an operation for gallstones.
Gallstones are the commonest cause of gallbladder cancer, with 8 out of 10 people diagnosed having them. Usually, they’ve had them for a long time and they are often large. Having gallstones doesn’t mean you’ll get cancer though. Around 1 in 100 people with gallstones go on to develop gall bladder cancer. It’s 3 times more common in women than it is in men. Other risk factors are:
- being overweight
- other medical conditions, called ‘porcelain gallbladder’ and primary sclerosing cholangitis
- being exposed to some toxins, including heavy metals, pesticides and a naturally occurring radioactive gas called radon
The most common symptoms of gallbladder cancer are:
- pain on the right of your tummy (abdomen), under your ribs
- raised temperature (fever)
- feeling or being sick
These are the same as a flare up of gallstones. If the cancer or stones are blocking the flow of bile, you may develop jaundice – yellowing of the skin and whites of the eyes.
Your cancer may be found when you are having an ultrasound of your liver for symptoms of gallstones. You may have a CT or MRI scan to check how far the cancer has grown and whether it has spread.
When gallbladder cancer is found very early during examination or treatment for gallstones, it can be cured with surgery to remove the gallbladder completely. It may be possible to remove it with surgery if it’s grown locally, through the gallbladder wall. You may have chemotherapy after surgery to lower the risk of the cancer coming back.
If the cancer has spread to nearby lymph nodes, you may have a much larger operation. Whether this is possible depends on:
- the type of gallbladder cancer you have
- where the cancer is
- whether you are well enough for major surgery
Fibrolamellar liver cancer
This is often thought of as a type of hepatocellular carcinoma (HCC). But it’s usually diagnosed in teenagers or adults under 40. Unlike many other liver cancer patients, they often don’t have any other type of liver disease.
Partly because it’s so rare, we don’t know what causes fibrolamellar liver cancer. Unlike other HCC, it doesn’t seem to be linked to hepatitis B or C, or any other liver condition.
Fibrolamellar liver cancer often has vague symptoms. You may:
- have tummy (abdominal) pain
- lose your appetite
- lose weight (without trying to diet)
- feel sick
You may also feel generally unwell and lacking in energy.
Your specialist may suspect you have fibrolamellar cancer from looking at a CT scan. But they will need a sample of liver tissue (a biopsy) to make sure. To do this, they usually numb the skin over the liver and put a thin needle in through the skin. They will watch on an ultrasound or CT scan while they do this, to make sure the needle is in the right place.
Doctors most often use surgery to treat fibrolamellar liver cancer. A healthy liver is able to regrow. As people with this type of cancer often have an otherwise healthy liver, surgeons are able to remove quite large areas. A small number of people have a liver transplant. These are big operations though and it can take up to a year to recover.
Angiosarcoma of the liver
Sarcomas are cancers of soft tissue. They can develop in blood vessels, muscles, nerve fibres and connective tissues. Angiosarcomas are sarcomas of blood vessels. They are extremely rare.
With angiosarcoma, you may have:
- tummy (abdominal) pain from a swollen liver
- yellowing skin and whites of eyes (jaundice)
- abdominal swelling caused by fluid collecting (ascites)
- weight loss (without trying)
Liver angiosarcoma has often already spread when it’s diagnosed. It can spread to different parts of the body, including the lungs and bones. So you may have symptoms related to cancer spread.
Liver angiosarcoma is most often diagnosed in people over 60. Exposure to some substances increase risk, including vinyl chloride, arsenic and radiation. It’s more common in men.
To diagnose angiosarcoma, you may have an ultrasound scan of your liver. Sometimes it’s found when people are having a scan for something else.
Unfortunately angiosarcoma can be a very fast growing cancer. If it’s possible to remove it, you may have surgery. But often, it is spread throughout the liver and this isn’t possible.
You may also have chemotherapy, with or without surgery.
This rare cancer of the liver is most often diagnosed in very young children. 9 out of 10 cases are diagnosed in children under 5, although most of these are under 2 years old.
In the early stages it doesn’t generally have symptoms. As the cancer grows children may:
- have tummy (abdominal) swelling
- have a painful lump in the tummy
- lose weight for no reason
- lose their appetite
- feel or be sick
Children don’t usually have the more common signs of liver problems, such as jaundice, because their liver is generally healthy. But they may be more prone to broken bones (fractures).
We don’t know what causes hepatoblastoma. Some children are more at risk, including:
- babies born prematurely who have a very low birth weight
- children exposed to hepatitis B
- children born with a condition called biliary atresia
- children with some genetic conditions, such as Beckwith-Wiedemann syndrome or chromosome disorders
Hepatoblastoma shows up well on both CT and MRI scans. But the doctor will need to confirm the diagnosis with a biopsy. The doctor will numb the area and then put a very thin needle through the skin and into the liver to get a sample of the liver tissue.
Doctors treat hepatoblastoma with surgery alone or surgery and chemotherapy. The treatment your child will have depends on:
- their test results
- whether it is possible to remove their cancer with surgery
- whether the cancer has spread anywhere else in the body
Surgery may be a liver resection or a liver transplant. Your child may have chemotherapy before or after their surgery. About 1 in 3 hepatoblastomas in the liver can be removed with surgery.
Hepatoblastoma can spread to the lungs, but even if the cancer has spread, it is sometimes possible to cure it. A single deposit of cancer in the lung can be removed with surgery. Sometimes the lung secondaries completely disappear after chemotherapy.
Support with a rare cancer
If you’re diagnosed with a rare cancer you have to cope with all the issues that a cancer diagnosis brings. You also have other issues that are related to the rarity of your condition. It can be harder to find information and get answers to your questions. When a condition is very rare, less is often known about it simply because less research has been done. You are far less likely to meet other people with the same condition, so there is less support that way.
These days, it’s often best to find support on line. There are support networks for rare cancers and for liver disease. Have a look at the BLT support page for some organisations that may be able to help.
Here is a small selection of organisations you may find helpful.
If you have a child with hepatoblastoma, the Children’s Liver Disease Foundation provide information about coping with childhood liver disease, leaflets, a helpline and family events.
The Rare Cancer Alliance provides information and has a forum for patients.
Sarcoma UK run a website and email support network for patients with soft tissue sarcomas.
Content last reviewed: October 2022
Next review date: October 2025