Fibrolamellar carcinomaA cancer that begins in the skin or in tissue that covers our inside body organs. (FLC), or fibrolamellar hepatocellular carcinoma (FL-HCC or FHCC), is a rare form of cancerA disease where abnormal cells split without control and spread to other nearby body tissue and/or organs. Cancer cells can also spread to other parts of the body through the bloodstream and lymph systems. that develops from the tissues lining the liver. FLC presents in patients without any prior liver damage, which makes it stand out from most other types of liver cancers.
FLC is considered to be a variant of hepatocellular carcinoma (HCC), which is the most commonly diagnosed primary liver cancer. HCC is generally diagnosed in people over 40 with chronicA long-lasting disease that changes slowly. liver conditions and has male prevalence. Contrastingly, FLC generally affects people under 40 years old who have not had any prior liver damage, and is diagnosed equally in males and females. Generally, FLC also has a better prognosisTo predict how a disease/condition may progress and what the outcome might be. than HCC.
Treatment
If FLC is detected, it will be staged and graded based on size, metastasisKnown as secondary cancer, it grows/spreads from the original/ primary cancer. (whether the cancer has spread to other parts of the body) and how the cancer cells
• the smallest, living parts of the body. Cells work together to form or build the body
• a human is made up of millions of Cells
• Cells reproduce themselves to make sure a body stays working
• sometimes Cells can be abnormal or damaged and these can be cancer cells
look under the microscope. Staging and grading helps your doctors determine the best treatment for you.
Cancers can be staged using the TNM staging system:
- T (tumour) indicates the size and depth of the tumour.
- N (nodes) indicates whether the cancer has spread to nearby lymphA clear fluid that moves through the body through the lymphatic system, carrying cells that fight infection. nodes.
- M (metastasis) indicates whether the cancer has spread to other parts of the body.
This system can also be used in combination with a numerical value, from stage 0-IV:
- Stage 0: this stage describes cancer cells in the place of origin (or ‘in situ’) that have not spread to nearby tissue.
- Stage I: cancer cells have begun to spread to nearby tissue. It is not deeply embedded into nearby tissue and had not spread to lymph nodes. This stage is also known as early-stage cancer.
- Stage II: cancer cells have grown deeper into nearby tissue. Lymph nodes may or may not be affected. This is also known as localisedOnly to one area/place of body. cancer.
- Stage III: the cancer has become larger and has grown deeper into nearby tissue. Lymph nodes are generally affected at this stage. This is also known as localised cancer.
- Stage IV: the cancer has spread to other tissues and organs in the body. This is also known as advancedAt a late stage, far along or metastatic cancer.
Cancers can also be graded based on the rate of growth and how likely they are to spread:
- Grade
• A score that tells how quickly a tumour might spread and grow by looking at how the abnormal cells and tissue look under a microscope.
• Grade is not the same as stage.
• Grading is different depending on the type of cancer.
I: cancer cells present as slightly abnormal and are usually slow growing. This is also known as a low-grade tumour. - Grade II: cancer cells present as abnormal and grow faster than grade-I tumours. This is also known as an intermediate-grade tumour.
- Grade III: cancer cells present as very abnormal and grow quickly. This is also known as a high-grade tumour.
Once your tumour has been staged and graded, your doctor may recommend genetic testing, which analyses your tumour DNA and can help determine which treatment has the greatest chance of success. They will then discuss the most appropriate treatment option for you.
Treatment is dependent on several factors, including age, stage of disease and overall health. The types of treatments generally don’t vary between adults and children.
Treatment options for FLC may include:
- Surgery, potentially including:
- Tumour resection.
- Hepatectomy (removal of part or all of the liver).
- Liver transplant (in extreme cases).
- Radiation therapy.
- Chemotherapy
• a chemical drug treatment to kill or slow-growing cancer Cells
• these drugs are called cytotoxic drugs
. - Therapeutic embolisation.
- Immunotherapy.
- Clinical trials.
- Palliative careLessening pain without curing the disease..
For more information on treatment options, please refer to the Rare Cancers Australia treatment options page.
Risk factors
Because of how rare FLC is, there has been limited research into the risk factors of this disease.
Early symptoms
Early-stage FLC is difficult to diagnose as there usually aren’t any symptoms. As the tumour progresses, symptoms may begin to appear, including:
- Abdominal, back and/or shoulder pain.
- Nausea and vomiting.
- Unexplained weight loss/loss of appetite.
- Fatigue.
- Jaundice (yellowing of eyes and/or skin).
Not everyone with the symptoms above will have cancer but see your general practitioner (GP) if you are concerned.
Some of the information regarding symptoms was obtained from the Fibrolamellar Carcinoma (FCL/FLHCC) page published by the National Cancer Institute.
Diagnosis/diagnosing
If your doctor suspects you have FLC, they will order a range of diagnostic tests to confirm the diagnosisUsing medical test results, identify and name a disease and/or condition., and refer you to a specialist for treatment.
Imaging & blood tests
The doctor will take images of your body using magnetic resonance imagingTaking images/photos of inside body parts using magnet rather than x-ray. (MRITaking images/photos of inside body parts using magnet rather than x-ray.), a computed tomography scan (CT scanA 3-D (three dimensional) x-ray pictures that gives more information than a normal x-ray.), x-ray, and/or positron emission tomography (PET scanA test that uses a radioactive drug to show a picture of how your tissues and organs are working. Also known as a positron emission tomography scan.), depending on where it is suspected the cancer is. The doctor may also look at other parts of the body and looks for signs of metastasis. Additionally, a bloodhello test may be taken to assessTo measure, look at and learn from. your overall health and help guide treatment decisions.
Biopsy
Once the location(s) of the cancer has been identified, the doctor will perform a biopsyTo take a small piece of body tissue and test it in a laboratory. to remove a section of tissue using a needle. The tissue sample will then be analysed for cancer cells.
