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Liver Disorders

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Hepatoblastoma

Malignant liver tumors account for two percent of all childhood cancers, with an incidence rate in the U.S. of 1.6 to one million children annually. As one of the most common hepatic malignancies, hepatoblastomas often occur in infancy and are linked to inherited genetic abnormalities in chromosome 11. The tumors are generally confined to one lobe and have a single center. Asymptomatic, hepatoblastomas first appear as a mass or enlargement in the right upper quadrant, usually before age five. Vomiting, abdominal or back pain and weight loss may mark advanced disease. This type of cancer is often associated with severe osteopenia (abnormally mineralized bone), though the link to liver dysfunction is unclear. Differential diagnosis from other non-liver masses is an important first step. Unless the tumor is small and limited to one lobe, preoperative chemotherapy is the standard treatment for new diagnoses; chemotherapy may be used post-surgery as well. If the cancer is unresectable, liver transplant is an option after chemotherapy. It is recommended that patients with hepatic malignancies be referred to a tertiary medical center for care.