Catholic University Catholic Hematology Hospital

Overview

Hepatoblastoma is a type of liver cancer that starts in the cells of the liver. Liver tumors in kids are pretty uncommon; they make up about 1-2% of all the cancers that children can get. Out of these rare liver tumors, more than half are malignant, meaning they're cancerous, and about 65% of those are hepatoblastomas. This cancer usually shows up in the right side of the liver and is most often found in really young kids, typically under three years old. Most of the time, hepatoblastomas don't initially cause any symptoms, so they're often first noticed by parents who feel a lump in their child's belly that wasn't there before.

Causes and Symptoms

The precise reasons why hepatoblastoma occurs aren't clear, but it's been seen more often in kids who have certain genetic conditions, like:

The most common sign of hepatoblastoma is a lump in the belly that doesn't cause any symptoms, which parents or doctors might find by chance during a routine check-up or after noticing a swollen abdomen.
As the tumor grows, it can start causing other symptoms, including belly pain, feeling sick and throwing up, not feeling hungry, losing weight without trying, and sometimes a fever.

Treatment

For hepatoblastoma, the main goal is to completely remove the tumor through surgery because this offers the best chance for a cure and improved survival. However, at the time of diagnosis, many cases—less than half—are ready for surgery, so a lot of patients start with chemotherapy to shrink the tumor first.

Hepatoblastoma tends to respond well to chemo, and doctors often use a mix of powerful medications like cisplatin, doxorubicin, vincristine, and 5-fluorouracil to attack the tumor. Radiation therapy isn't always part of the plan for hepatoblastoma, but it might be used in certain situations, like if the tumor can't be operated on or if there's some tumor left after surgery and chemotherapy.

If the tumor still can't be removed after trying several rounds of chemotherapy, a liver transplant might be the next step to consider. There's also some promising research on a drug called sorafenib, which is a type of targeted therapy that goes after specific parts of cancer cells. It's already being used for pediatric liver cancer and might turn out to be helpful for hepatoblastoma as well.