Key Points about Fibrolamellar HCC

  • Fibrolamellar HCC is the most common type of primary liver cancer.
  • Doctors use imaging tests, biopsy, blood tests and physical exams to diagnose this type of cancer.
  • Treatment for fibrolamellar HCC may include chemotherapy, radiation therapy, targeted therapy, liver transplant, immunotherapy and/or surgery.


Fibrolamellar hepatocellular carcinoma (HCC) is the most common type of primary liver cancer – meaning that the cancer initially occurs in the liver. Most people who develop fibrolamellar HCC also have another chronic liver condition, such as hepatitis B or hepatitis C.

Fibrolamellar HCC causes

This type of cancer is caused when the liver cells develop mutations (changes) to their DNA.

Fibrolamellar HCC risk factors

The following factors may increase your risk for developing this condition:

  • Having a fatty liver
  • Having hepatitis B
  • Having hepatitis C
  • Drinking excessive amounts of alcohol

Fibrolamellar HCC symptoms

In its early stages, this condition usually doesn’t cause any symptoms.

Fibrolamellar HCC diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

  • Physical exam – your doctor will perform a complete physical exam, including asking questions about your health history, symptoms and related risk factors.
  • Biopsy – in this test, your doctor removes a biopsy (small sample) from the suspicious area. This sample is sent to the laboratory, where a specialist closely checks the biopsy for signs of fibrolamellar HCC.
  • Blood test – your doctor sends a sample of your blood to the laboratory for close analysis. The lab technician checks the sample to see if your liver function is normal.
  • Computerized tomography (CT) scan – this type of imaging test provides a 3D image of the inside of the body that your doctor can use to determine the location and/or stage of the cancer.

Fibrolamellar HCC treatments

Depending on your personal health history, the extent of the cancer and other factors, your oncologist may recommend one or more of the following treatment options:

  • Surgery – you may need to undergo surgery to remove the cancerous area. Your surgeon will work to preserve as much surrounding healthy tissue as possible.
  • Liver transplant – if your cancer is advanced, your specialist may recommend you undergo a liver transplant. During this surgical procedure, your surgeon removes your diseased liver and replaces it with a healthy liver from a donor.
  • Chemotherapy – during this treatment, you will take medications that work to destroy the cancer. The medication is delivered either orally (by pill) or intravenously (by vein).
  • Immunotherapy – this treatment works with your body’s own immune system to destroy cancerous cells.
  • Radiation therapy – this treatment uses high-powered energy beams to destroy cancerous cells. You may need to undergo radiation therapy to destroy any cancerous cells that couldn’t be removed surgically.
  • Targeted therapy – in this treatment, medications are used to target certain vulnerabilities of the cancer. This works to destroy the cancerous cells.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.

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