(1) Symptoms Early liver cancer often has nonspecific symptoms, while the symptoms of middle and late liver cancer are more numerous. Common clinical manifestations include pain in the liver area, abdominal distension, poor appetite, fatigue, lethargy, progressive hepatomegaly or epigastric mass, etc. Some patients may have low-grade fever, jaundice, diarrhea, upper gastrointestinal tract hemorrhage, and acute abdominal manifestations after rupture of liver cancer, etc. There may also be symptoms that are not obvious or only show metastatic foci. There are also symptoms that are not obvious or only show the symptoms of metastatic foci.

(2) Signs and symptoms Early liver cancer often has no obvious positive signs or only resembles cirrhosis signs. In middle and late stage liver cancer, signs such as liver enlargement, jaundice and ascites usually appear. In addition, those who are combined with cirrhosis often have liver palms, spider nevus, enlarged male breast and lower limb edema. When extrahepatic metastasis occurs, the corresponding signs of each metastatic site may appear.

(3) Complications: upper gastrointestinal bleeding, rupture and bleeding of hepatocellular carcinoma, hepatic and renal failure, etc. are common.

2. Secondary hepatocellular carcinoma

(1) Clinical manifestations of the primary tumor are mainly seen in patients with no history of liver disease. Liver metastasis is still in the early stage, and there are no corresponding symptoms, whereas symptoms of the primary tumor are mostly in the middle or late stage. Secondary hepatocellular carcinoma in such patients is mostly found in the examination and follow-up of primary treatment.

(2) Clinical manifestations of secondary hepatocellular carcinoma Patients mostly complain of dullness and discomfort or vague pain in the epigastric or hepatic area, and with the development of the disease, patients may have fatigue, poor appetite, emaciation, or fever, etc. On physical examination, patients may have symptoms in the middle and upper abdomen. During physical examination, enlarged liver can be detected in the middle and upper abdomen, or hard nodules with hard texture and tenderness, and patients with advanced stage may have anemia, jaundice and ascites. The clinical manifestations of these patients are similar to those of primary liver cancer, but the development is relatively slow and the degree is relatively mild. Most of them are suspected to have metastasis during various examinations of the liver, and the primary tumors are found during further examinations or surgical exploration. In some patients, the primary tumor could not be found after various examinations.

(3) Clinical manifestations of both primary tumor and secondary liver cancer It is mainly seen that the primary tumor and metastatic cancer of liver are not in the early stage, and in addition to the symptoms and signs of liver similar to those of primary liver cancer, the patients also have the clinical manifestations caused by the primary tumor, for example, liver metastasis of colorectal and rectal cancers can be accompanied with changes in defecation habits, feces characteristics, and blood in stools, etc.

There are also some cases of liver metastasis of colorectal and rectal cancers.