Pediatric liver (hepatic) tumors

What are pediatric liver (hepatic) tumors?

Hepatic (liver) cancer is rare in children. The most common mass in younger children is hepatoblastoma. Older adolescents are more likely to be diagnosed with hepatocellular carcinoma, which more readily metastasizes (spreads to other parts of the body).

What are the different types of pediatric liver (hepatic) tumors?

• Mesenchymal hamartomas (usually benign)
• Sarcomas
• Hepatocellular carcinomas

How are pediatric liver (hepatic) tumors diagnosed?

Diagnosing liver cancer includes distinguishing them from other non-malignant masses such as hemangiomas, which are the most common benign liver mass.

• Hemangiomas - These are most often found in infants less than 6 months old.
• Mesenchymal hamartomas - These are rare benign masses usually found in children under 2 years old.
• Hepatoblastoma - Although malignant, usually does not spread beyond the liver. About 90% of hepatic malignancies in children age 4 or younger are hepatoblastomas. The tumor is associated with a number of genetic conditions.
  • Beckwith Wiedemann syndrome
  • Familial adenomatous polyposis
  • Glycogen storage diseases
• Hepatocellular carcinoma - This has a lower 5-year survival rate than that for hepatoblastoma. The carcinoma is associated with some familial syndromes and in some regions with a high incidence of Hepatitis B, which children acquire perinatally.

Other types of liver malignancies are even rarer:

• Undifferentiated embryonal sarcoma of the liver, which usually occurs in children between age 5 and 10 years.
• Infantile choriocarcinoma of the liver which originates in the placenta and appears in a young infant’s liver.
• Epithelioid hemangioendothelioma is a rare vascular cancer.

What testing is doing to diagnose pediatric liver (hepatic) tumors?

• Children with a liver malignancy usually have a painless mass or swelling in the abdomen. Some children have pain, nausea, vomiting and unexplained weight loss.
• Serum tumor markers can identify elevated beta-human chorionic gonadotropic or alpha-fetoprotein levels.
• Liver function tests (LFT) and blood chemistry studies can indicate liver disease.
• Imaging in children usually begins with ultrasonography and may be followed by computed tomography (CT) and magnetic resonance imaging (MRI) as necessary.
• A biopsy confirms diagnosis and immunohistochemistry may be used to determine genetic causes of liver tumors.