In these areas, there is a high prevalence of chronic infection with the hepatitis B virus, which increases the risk of hepatomas more than 100-fold. Chronic infection with hepatitis C also increases the risk of hepatomas. In subtropical regions where hepatomas are common, food is often contaminated by carcinogens called aflatoxins, substances that are produced by certain types of fungi. In North America, Europe, and other areas of the world where hepatomas are less common, most people with hepatomas are alcoholics with long-standing liver cirrhosis. Additional types of cirrhosis are also associated with hepatomas, though the risk is lower with primary biliary cirrhosis than with other types.
Fibrolamellar carcinoma is a rare type of hepatoma that usually affects relatively young adults.
It isn't caused by preexisting cirrhosis, hepatitis B or C infection, or other known risk factors. Symptoms Usually, the first symptoms of a hepatoma are abdominal pain, weight loss, and a large mass that can be felt in the upper right part of the abdomen. Alternatively, a person who has had cirrhosis for a long time may unexpectedly become much more ill. A fever is common. Occasionally, the first symptoms are acute abdominal pain and shock, caused by a rupture or bleeding of the tumor.