Primary cancer of the liver in the absence of cirrhosis is unusual, and most reports on the subject are from autopsy observations. Hepatoma in an otherwise normal liver may originate in the parenchymatous liver cells or in the intrahepatic bile ducts. This tumor may grow slowly for years before it spreads through hepatic vessels or metastasizes widely. The symptoms usually are mild indigestion or disturbance caused by the size and weight of the tumor, but massive intra-abdominal hemorrhage has occurred.
Few surgeons have reported on resectable hepatoma. In the literature I have been able to find 29 cases, in 7 of which the tumor originated in the right lobe. Of the 23 patients who survived operation, there was no later report of 3, and 8 died of recurrence. A primary hepatoma may be encapsulated and appear benign; it may grow very slowly; it may have areas of cystic degeneration, or