Sarcoma in the liver: the types found in adults and what they mean | CION Cancer Clinics

A sarcoma is a cancer that starts in the body's supporting tissue: blood vessel walls, muscle, fat or the fibrous tissue that holds organs together. In the liver it is rare. Most liver cancers in adults start in the liver cells themselves or in the bile ducts, and most cancer found in the liver has spread there from somewhere else.

First, is it starting in the liver or travelling to it?

This is the question that changes everything else. A sarcoma that starts in the liver is called a primary liver sarcoma. A sarcoma that began in the stomach wall, the womb, the back of the abdomen or a limb and then spread to the liver is a secondary one. The second situation is more common than the first. It is treated as the original sarcoma, by the team that knows that sarcoma, not as a liver cancer. If you are not sure which one your report describes, our page on primary and secondary liver cancer explains how doctors tell them apart.

Why the name on the report matters so much

"Sarcoma" is a family name, not a single disease. There are several kinds that can appear in the liver, and they behave very differently. Some grow slowly over years. Others grow fast. The exact type, read by a pathologist who sees sarcomas often, is what the whole plan rests on.

When a primary liver sarcoma is in one area and the rest of the liver is healthy, surgery to remove it with a clear margin is usually the main hope of long-term control. CION's surgical oncologists assess and plan liver operations, and your team will tell you where the operation takes place.

When surgery is not possible

Chemotherapy, given at CION centres, is used to shrink or slow a sarcoma that cannot be removed or has spread. The drugs depend on the type. Angiosarcoma responds to different medicines from leiomyosarcoma, and EHE may need no medicine at all for a time. GIST is treated with targeted tablets rather than standard chemotherapy. Procedures such as TACE, which blocks the tumour's blood supply, are sometimes used to stop bleeding and are coordinated through partner hospitals.

About transplant

A liver transplant is not usually offered for angiosarcoma, because the cancer tends to come back in the new liver. It is considered for some people with EHE at licensed transplant centres. For secondary sarcoma, the plan follows the original sarcoma, as on our page about treating sarcoma that has spread.

It cannot tell you what your scan shows or which type you have. Only a biopsy read by an experienced pathologist can do that. It also cannot tell you how things will go for you, because these tumours are rare and published experience is small. Be wary of any outlook figure you find online, which may come from a handful of cases in another country.

Who this page does not apply to

This page is about adults. A liver tumour in a young child is most often a hepatoblastoma, which is planned by a children's cancer team; see hepatoblastoma in children. If your report says hepatocellular carcinoma or cholangiocarcinoma, the sarcoma treatments described here do not apply to you.