ICD-11

The most frequent and important hepatic neoplasm is the primary hepatocellular carcinoma (HCC). In many parts of the world, in particular Africa and Asia, it poses a significant disease burden. In these high incidence regions, chronic infection with hepatitis B virus (HBV) is the principal underlying cause, with the exception of Japan which has a high prevalence of hepatitis C infection. HBV vaccination has become a powerful tool in reducing cirrhosis and HCC, but implementation is still suboptimal in several high risk regions. In Western countries, chronic alcohol abuse is a major aetiological factor. Hepatic cholangiocarcinoma has a different geographical distribution, with peak incidences in Northern Thailand. Here, it is caused by chronic infection with the liver fluke, Opisthorchis viverrini, which is ingested through infected raw fish.

Combined hepatocellular-cholangiocarcinoma is a tumour containing unequivocal, intimately mixed elements of both hepatocellular carcinoma and cholangiocarcinoma.