Primary liver cancer starts in the liver cells (hepatocellular carcinoma) or bileduct cells within the liver; it forms tumors that can invade nearby tissues and spread to lymph nodes or distant organs.

Early symptoms may be absent or vague: unexplained weight loss, loss of appetite, fatigue, abdominal pain or fullness (especially right upper abdomen), jaundice, swollen abdomen from fluid, and easy bruising or bleeding.

Major risk factors include chronic viral hepatitis (B or C), longterm heavy alcohol use, nonalcoholic fatty liver disease, cirrhosis from any cause, certain inherited liver diseases, and exposure to aflatoxin; some people develop liver cancer without clear risk factors.

Diagnosis uses medical history, physical exam, blood tests including liver function and tumor markers, and imaging such as ultrasound, CT or MRI; tissue biopsy may be required in some cases to confirm the diagnosis and guide treatment.

Treatment depends on tumor type, size, location, liver function, and overall health: options include surgical removal or liver transplantation for eligible patients, local ablation, transarterial therapies, systemic chemotherapy or targeted/immunotherapies, and palliative measures to control symptoms.