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Hepatoblastoma, a liver cancer, is a very rare condition in children, with an estimated 0.9 per 1 million children experiencing the condition, according to St. Jude Children’s Hospital. Hepatoblastoma is most commonly diagnosed in children from infancy to about 3 years old. Many cases of hepatoblastoma are first noted as an abdominal mass that parents or a physician discover while bathing or examining the child.

The liver is an important organ responsible for filtering blood and toxins in the body. It’s also one of the body’s largest organs and has two lobes: right and left lobes. Hepatoblastoma means uncontrolled growth of cancer cells inside the liver. Hepatoblastoma causes problems because the cancer cells interfere with the normal function of the liver cells. This may include:

  • Anemia, which causes pale skin and lips
  • Appetite loss
  • Back pain, as a liver tumor can compress the spine
  • Fever
  • Itching
  • Jaundice
  • Stomach pain
  • Swollen abdomen
  • Unexplained vomiting
  • Weight loss

While some causes of hepatoblastoma are unknown, a family history of certain genetic conditions and childhood illnesses may increase a child’s risk for experiencing hepatoblastoma. Examples include:

  • Beckwith-Wiedemann syndrome, an overgrowth disorder that causes high birth weight and low blood sugar
  • Familial adenomatous polyposis (FAP), a condition where polyps grow on the colon and rectum
  • Hemihyperplasia, a condition where one side of the body grows faster than the other
  • Hepatitis B virus passed from mother to child
  • Low birth weight and prematurity
  • Tyrosinemia, a rare genetic disorder that causes high levels of the protein tyrosine

Hepatoblastoma is not the same condition as hepatocellular carcinoma, a cancer form that occurs when infection, drugs, or a metabolic condition injures the liver. Hepatocellular carcinoma is more common in adults than children.

Diagnosis 

A large abdominal mass or yellowing of the skin alerts a doctor that something is wrong. From there, imaging studies such as an abdominal ultrasound and then a CT “cat” scan or MRI allow doctors to “see” the tumor.

Blood tests allow doctors to determine how well the liver is functioning and give them a clue about the nature of the mass and if it’s causing any other problems. Finally, a biopsy or tissue sample taken by a surgeon while the child is under anesthesia confirms that the mass is indeed a hepatoblastoma.

Treatment for hepatoblastoma typically begins with removing the tumor, if possible. An estimated 30 percent of all hepatoblastoma cases involve a tumor that can be surgically removed, according to the National Cancer Institute. The outcomes tend to be more favorable in children whose tumors can be fully removed via surgery. Other children may require a liver transplant to eliminate cancerous cells. Chemotherapy, or medications to kill fast-growing cells, may be used to shrink the tumor prior to surgery.

The survival rates for hepatoblastoma can vary widely depending on how far the tumor has spread at diagnosis, a child’s age, and the tumor’s response to treatment (chemo).

Reviewed by Dr. Sara Connolly, November 2019

Takeaways

  • Hepatoblastoma is a rare cancer of the liver that typically affects infants and young children. It is the 10th-most common childhood cancer.
  • The first sign is often a lump in the abdomen.
  • Treatment typically begins with removing a tumor, but some children may require a liver transplant.

References

  1. The Children’s Hospital of Pennsylvania. Hepatoblastoma (Liver) In Children.
  2. Lucile Packard Children’s Hospital at Stanford. Hepatoblastoma.
  3. National Cancer Institute. Childhood Liver Cancer Treatment.
  4. National Cancer Institute. Hepatoblastoma and Hepatocellular Carcinoma.
  5. St. Jude Children’s Research Hospital. Hepatoblastoma.

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