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Hepatoblastoma

 Hepatoblastoma



Overview

Hepatoblastoma (pronounced “hep-ah-to-blas-to-mah”) is a very rare liver cancer that typically affects children ages 1 to 3. Surgeons may be able to cure hepatoblastoma if it’s diagnosed when liver cancer tumors are small enough to be completely removed with surgery. Medical researchers are evaluating ways to treat hepatoblastoma that surgery can’t remove or that’s spread (metastasized).

Hepatoblastoma is a rare, malignant (cancerous) tumor of the liver. It is found 90 percent of the time before 3 years of age.

The cause of hepatoblastoma is most often not known. Some genetic disorders put a child at greater risk.

Symptoms

Hepatoblastoma develops over time. If your child has hepatoblastoma, you may not notice any changes in your child’s body until the tumor in their liver has grown large enough to affect their overall health or behavior. Common symptoms include:

A painful lump in the middle or upper right side of your child’s belly (abdomen).

Persistent nausea and vomiting.

Loss of appetite.

Abdominal pain.

Yellow-colored skin or eyes from jaundice that happens when bilirubin builds up in your child’s body.

Unexplained weight loss.

Causes

Medical researchers haven’t identified the exact cause, but they have pinpointed some risk factors, including certain genetic (inherited) conditions. Risk factors include:

Premature birth: Most babies are born at 37 weeks or later. A baby born before 37 weeks is considered premature.

Low birth weight: Babies weighing less than 5.5 pounds at birth.

Early exposure to hepatitis B, which attacks your child’s liver.

Biliary atresia: This condition affects newborn babies, keeping bile from flowing to their small intestines. The backed-up bile damages their livers.

Hemihyperplasia: This condition causes one side of your child’s body to be larger than the other side.

Beckwith-Wiedemann syndrome: This inherited growth disorder increases the risk of developing childhood cancer, including hepatoblastoma.

Familial adenomatous polyposis (FAP): People with this condition are born with a mutated APC gene. FAP causes pre-cancerous polyps in your child’s large intestine.

Aicardi syndrome: This condition affects your child’s brain and eyes and causes them to have seizures.

Glycogen storage disease (GSD): This disease affects the way your child’s body processes glucose (sugar).

Simpson-Golabi-Behmel syndrome (SGB): Children born with SGB grow and gain weight at an unusually rapid rate. They may develop conditions in early childhood, including umbilical hernias and tumors.

Edwards syndrome (trisomy 18): Recent studies have some links between this inherited disorder and hepatoblastoma in the small number of children with Edwards syndrome who live for more than a year.

Diagnosis

Healthcare providers use several tests to diagnose hepatoblastoma. Those tests include:

Alpha-fetoprotein (AFP) tests: AFP is a substance produced by your child’s liver.

Comprehensive metabolic panel (CMP): A CMP tests your child’s blood for 14 different substances and liver function.

Vascular ultrasound: This test gives providers a view of the network of blood vessels entering and leaving your child’s liver.

Complete blood count (CBC):This test measures and counts the blood cells in your child’s blood.

Liver and Doppler ultrasounds: Providers use these tests to obtain images of the inside of your child’s liver.

Magnetic resonance imaging (MRI): This painless test uses a large magnet, radio waves and a computer to produce very clear images of organs and structures within your child’s body.

Tests are essential. But needles can sting and MRI machines make loud, scary noises, so it makes sense if your child becomes tearful or upset before or during tests. Talk to your child’s healthcare provider. They may recommend you work with a child life specialist to help you and your child. Here are some ways you can make essential tests easier:

Many times, children cope better with pain and tests if they know what to expect. Ask your child’s provider to walk you through the test so you can talk to your child about the process.

Play “let’s pretend” with your child, using the test as the game. For example, if your child will have an MRI, you and your child can practice holding still for the same amount of time the procedure will take.

Very young children want their parents nearby. Ask your provider about your child’s tests so you know when you can stay with your child and when you can’t.

When you can stay with your child, plan ways to distract them during the procedure like reading a favorite book, telling a favorite story or helping them imagine a favorite activity. Sometimes, simply being there to hold their hand is all they need.

When you can’t stay with your child, ask if they can have a favorite soft toy or blanket to hold during the test. It may help to tell your child that even if they can’t see you, you’ll be right there during the test.

Do your best to stay calm for your child’s sake.

Treatment

Healthcare providers typically treat hepatoblastoma with partial hepatectomy, removing the parts of your child’s liver that have tumors. They may combine surgery with the following treatments:

Chemotherapy: Providers may use chemotherapy to shrink tumors before surgery. Chemotherapy may be systemic or local. Systemic chemotherapy travels throughout your child’s body. Local chemotherapy directly targets the tumor in your child’s liver.

Transarterial chemoembolization (TACE): This treatment works the same way you might build a dam in a stream to stop the stream from flowing. Providers inject anti-cancer drugs into one of the arteries that supplies blood to your child’s liver. Then, they inject a substance to block the artery. The substance acts like a dam, keeping the anti-cancer drugs swirling around the tumor instead of floating away.

Radiation therapy: Providers may use radiation therapy after surgery to remove any remaining cancer cells or as an alternative way to treat tumors that surgery can’t remove.

Ablation therapy: This treatment destroys or removes tissue. Providers use ablation therapy to treat recurring hepatoblastoma.

Liver transplantation: Your child’s surgeon may recommend a liver transplant if tumors in your child’s liver are too large to remove with surgery

Type of Doctor Department :A Pediatric Oncologist

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