Hepatoblastoma is a rare form of liver cancer that occurs in young children

Hepatoblastoma is a rare form of liver cancer. Doctors diagnose about 100 cases of hepatoblastoma per year in the U.S. Nearly all cases of hepatoblastoma occur in children ages three and younger.

Fortunately, hepatoblastoma in children is usually curable when doctors find it early. These tumors rarely spread to other organs.

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Hepatoblastoma Causes

Doctors don’t know for sure what causes hepatoblastoma. Most likely, cells inside the child’s liver didn’t grow and divide correctly during pregnancy or the first years of life.

Being born prematurely seems to be a risk factor for hepatoblastoma. As many as 20% of children with hepatoblastoma were born prematurely. But doctors don’t fully understand the connection between prematurity and hepatoblastoma.

Some genetic conditions may make a child more likely to develop hepatoblastoma. These include:

Doctors have observed that:

  • Hepatoblastoma is more common in boys than girls.
  • White children are almost five times more likely to develop hepatoblastoma than Black children.
  • Black children are more likely to have worse outcomes.

Unfortunately, doctors can’t explain these trends, but research is underway.

Hepatoblastoma Symptoms

Hepatoblastoma symptoms in children are often vague. It may be easy to overlook them. Common symptoms include:

  • Pain in abdomen.
  • Swollen abdomen.
  • Loss of appetite.
  • Unexplained weight loss.
  • Fever.
  • Fatigue.
  • Weakness.
  • Nausea and vomiting.
  • Dark urine.
  • Itchy skin.
  • Yellowing of the skin and/or the whites of the eyes (jaundice).

These symptoms can also have other, less serious causes. Contact your child’s pediatrician with any questions or concerns.

Hepatoblastoma Treatment

If your child receives a hepatoblastoma diagnosis, you’ll want to seek treatment at an academic medical center with a specialty liver disease program. Your child will need coordinated interdisciplinary care from a team that includes:

  • Pediatricians.
  • Oncologists.
  • Hepatologists.
  • Gastroenterologists.
  • Transplant physicians.
  • Nurses with specialized pediatrics and oncology training.
  • Nutritionists.
  • Psychologists.
  • Social workers.
  • Physical and occupational therapists.

In general, hepatoblastoma treatment for children consists of surgery and chemotherapy. Radiation therapy may also help. Liver transplant may also be an option.

Surgery

Your child’s doctor may perform a surgical biopsy to remove a small piece of the tumor for diagnosis.

If doctors can operate successfully, expect a second surgery after the biopsy. In many cases, doctors can remove the entire hepatoblastoma via surgery.

Chemotherapy

Your child may also need IV chemotherapy with a drug like cisplatin to treat their hepatoblastoma. Your child’s doctor may give the chemotherapy before or after surgery. The timing will depend on the tumor’s exact size and location.

Your child may also receive chemotherapy directly into the liver. This procedure can increase the chemotherapy’s effectiveness while also preventing the tumor from getting the oxygen and nutrients it needs.

Radiation therapy

This type of therapy uses X-rays to kill cancer cells and shrink tumors. Your child’s medical team may use a machine outside the body to deliver the radiation. Or they may put radiation-producing materials inside the body at the tumor.

Liver transplant

Liver transplant may be an option if the tumor’s size and location inside the liver make removal surgery too dangerous. Surgeons will remove your child’s diseased liver and replace it with one from an organ donor. UPMC is a world leader in transplant medicine for both children and adults.

According to UPMC estimates, about 20% of children with hepatoblastoma may require liver transplantation.

If the tumor has not spread outside the liver, your child’s long-term outlook is very good. Up to 80 % of children treated with liver transplant survive longer than 20 years with no recurrences.

Looking Ahead

It’s important to know that hepatoblastoma survivors will need ongoing medical care and monitoring. There is a small chance that your child’s cancer may come back after treatment.

But hepatoblastoma treatment in children has a high success rate. Your child’s medical team will be there to support you every step of the way.

Sources

Pediatric Hepatoblastoma. Medscape. Link

Medline Plus. Beckwith-Wiedemann syndrome. National Library of Medicine. Link

Medline Plus. Familial adenomatous polyposis. National Library of Medicine. Link

Pediatric Liver Transplant Program at UPMC Children's Hospital of Pittsburgh. Link

Hepatoblastoma (Liver Cancer) in Children: Symptoms and Treatment. Children's Hospital of Pittsburgh. Link

About Center for Liver Diseases

The UPMC Center for Liver Diseases provides complete care for a variety of liver conditions. Our expert hepatologists manage and treat patients using cutting-edge practices and therapies. We research and evaluate new treatments to provide the best care possible. We manage your care and, if necessary, can help you make the transition to subspecialists, including transplant surgery and oncology.