Hepatoblastoma is a very rare cancerous tumor that starts in the liver. The liver is one of the largest organs in the body. The main function of the liver is a place for screening and storing blood. The liver consists of the right and left lobes.
Hepatoblastoma generally attacks children, from infants to 3 years of age. Hepatoblastoma cancer cells can spread (metastasis) to other areas of the body, although this is rare.
What causes hepatoblastoma?
Although the exact cause of liver cancer is unknown, there are a number of genetic conditions associated with an increased risk of hepatoblastoma, including Beckwith-Wiedemann syndrome, Wilson's disease, porphyria cutanea tarda, and familial adenomatous polyposis. Other genetic conditions associated with liver cancer include some congenital metabolic disorders such as tyrosinemia, glycogen storage diseases, and alpha1-antitrypsin deficiency.
Children who have hepatitis B or C infection at an early age, or those who have biliary atresia, also have an increased risk of hepatocellular carcinoma. Some hepatoblastoma have genetic changes in tumor suppressor genes as triggers of uncontrolled cell growth.
What are the symptoms of hepatoblastoma?
The following are the most common symptoms of hepatoblastoma. However, each child may experience different symptoms. Symptoms can vary depending on the size, presence and location of tumor metastases. These symptoms, including:
- Swollen abdomen
- Weight and appetite decrease
- Early puberty in boys
- Stomach pain
- Nausea and vomiting
- Jaundice (yellowing of the eyes and skin)
- Itchy Skin
- Veins in the abdomen are enlarged and can be seen through the skin
Symptoms of hepatoblastoma may resemble other conditions or medical problems. Make sure you always consult your pediatrician for an accurate diagnosis.
How to diagnose hepatoblastoma?
In addition to a complete medical history and physical examination, the diagnostic procedure for hepatoblastoma includes:
- Biopsy - tissue samples from the tumor are taken and examined under a microscope.
- Complete blood count (CBC) - measurement of the number, size and maturity of different blood cells in a certain volume of blood.
- Additional blood tests - may include blood chemistries, blood-clotting tests, evaluation of liver and kidney function, and genetic studies.
- Computed tomography scans (also called CT or CAT scans) - diagnostic imaging procedures that use a combination of x-rays and computer technology to produce a horizontal, or axial body image. CT scans show detailed images of each part of the body, including bones, muscles, fat, and organs. CT scan results are more detailed than X-rays in general.
- Magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radio frequencies, and computers to produce detailed images of organs and structures in the body.
- X-rays or X-rays - diagnostic tests, which use invisible rays of electromagnetic energy to produce images of internal tissues of bones and organs.
- Ultrasound (also called sonography) - a diagnostic imaging technique that uses a computer and high frequency sound waves to make images of blood vessels, tissues, and organs. Ultrasound is used to see the functions of internal organs and to observe blood flow through various vessels.
- Alpha-fetoprotein (AFP) test - The level of alpha-fetoprotein (AFP) in the blood can be used to diagnose and monitor the response to treatment.
Various hepatoblastoma stages
Staging or stadium is a process of determining how far the cancer has spread. There are various stadium symptoms that are used for hepatoblastoma. Make sure you always consult with your pediatrician for information about the stage of cancer. One method of hepatoblastoma stage includes the following stages:
- Stage I - usually the tumor is only present in the liver and can be completely removed through surgery.
- Stage II - usually the tumor can be removed surgically, but a small amount of cancer remains in the liver.
- Stage III - usually the tumor is completely removed or cancer cells are found in the closest lymph nodes.
- Stage IV - cancer has spread (metastasis) to other parts of the body.
- Recurrence - the disease relapse after it has been treated. This disease may re-attack the liver or other parts of the body.
How do you treat hepatoblastoma?
Treatment for hepatoblastoma depends on the following factors:
- Your child's age, health condition, and medical records
- The severity of the disease
- Child's tolerance for certain drugs, procedures and therapies
- Expectations of disease progression
- Your opinions or preferences
Treatment of hepatoblastoma is generally aimed at resecting (removing) the tumor as much as possible while maintaining the performance of liver function. Liver tissue can regenerate when removed.
Other treatments (either alone or in combination) include:
- Surgery (to remove the tumor and part or all of the liver)
- Liver transplantation
- Radiation therapy
- Percutaneous ethanol injection - injecting alcohol (ethanol) through a small needle, right in the part of the tumor to kill cancer cells
- Be alert and patient - do not start treatment until symptoms appear or change
The long-term outlook and life expectancy for children with hepatoblastoma is very dependent on:
- Extent of disease
- Size and location of the tumor
- The presence or absence of metastasis
- Tumor reaction to therapy
- The age and health condition of your child
- Child's tolerance for certain drugs, procedures or therapies
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