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What Is Hepatoblastoma?

Hepatoblastoma is a rare type of cancer that causes a tumor to grow in the liver. Hepatoblastoma (heh-puh-toe-blass-TOE-muh) tends to affect children under age 3. It rarely spreads (metastasizes) beyond the liver.

What Are the Signs & Symptoms of Hepatoblastoma?

A child with hepatoblastoma can have many of these symptoms:

  • a large belly that sticks out
  • belly pain
  • mass in the belly (something solid that can be felt through the skin)
  • jaundice (yellow skin or eyes)
  • dark pee
  • back pain
  • fever
  • itching
  • large veins that can be seen in the skin around the belly
  • loss of appetite
  • weight loss
  • nausea and vomiting 

A boy with hepatoblastoma may have puberty-like growth of the penis, testicles, and pubic hair. 

What Causes Hepatoblastoma?

Doctors don't know the exact cause of hepatoblastoma. But some genetic problems and liver inflammation (redness and swelling) caused by viral infections, like hepatitis B or hepatitis C, increase a child's risk for it. 

Who Gets Hepatoblastoma?

Children are more likely to get hepatoblastoma if they:

  • are born early with a very low birth weight 
  • have a growth disorder called Beckwith-Wiedemann syndrome (which makes the body and internal organs grow too much or get too big)
  • have a genetic condition called familial adenomatous polyposis (which causes growths in the lining of the large intestine)

Hepatoblastoma is more common in boys than in girls.

How Is Hepatoblastoma Diagnosed?

When a child has hepatoblastoma symptoms, the doctor will do a physical exam. Tests done may include:

  • blood tests, including liver and kidney function tests
  • imaging tests:
  • a biopsy: removing a piece of tumor tissue with the help of X-rays (image-guided procedure)

How Is Hepatoblastoma Treated?

Doctors usually treat hepatoblastoma with a combination of surgery and chemotherapy. If possible, children with cancer should go to a medical center specializing in the treatment of pediatric cancers.

A child's treatment depends on:

  • the child's age
  • the size of the tumor
  • whether the cancer has spread from the liver

Treatment may include:

  • surgery to remove the tumor along with some or all of the liver
  • chemotherapy
  • chemoembolization (injecting chemotherapy drugs into the tumor to block its blood vessels)
  • radioembolization (using radiation and embolization to treat the tumor and block the blood supply to the cancer cells)
  • radio frequency ablation (RFA; using radio waves to shrink the tumor)
  • radiation therapy (including proton beam therapy)

The liver is a vital organ. So a child will need a liver transplant if the entire liver is removed to treat the cancer.

Hepatoblastoma is treated by a health care team, including specialists in:

  • oncology (cancer)
  • hematology (blood diseases)
  • surgery
  • gastroenterology (digestive tract) and hepatology (liver)
  • pathology (diagnosing diseases by examining body tissues, fluids, and organs )
  • genetics (genetic counseling and testing)
  • radiology (medical imaging)
  • radiation oncology (radiation treatment)
  • interventional radiology (image-guided minimally invasive procedures)
  • behavioral health (psychology and psychiatry)
  • nutrition
  • oncologic nursing (nurses specialized in treating people with cancer)

Looking Ahead

Hepatoblastoma usually does not spread from the liver to other parts of the body. If a surgeon removes the cancer completely, the outlook is generally good.

After treatment, a child will have a checkup every year to see if the cancer has come back, but this doesn't happen in most cases. The doctor will also treat any long-term or late side effects from the treatment.

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