What is a malignant liver tumour?

Malignant liver tumours in children are rare. There are two main types, hepatoblastoma, which usually occurs in children under 5 years, and hepatocellular carcinoma, which occur in older children.

Signs & Symptoms

The most common symptom is an abdominal mass or abdominal distension, which may sometimes be accompanied by pain. Other less common symptoms are loss of appetite, vomiting, weight loss and lethargy. Rarely jaundice (a yellowish tinge to the skin or whites of the eyes) may occur.

Diagnosis

Investigations will include abdominal and lung CT scans, chest x-ray and sometimes a MRI scan. These scans show the size and site of the tumour within the liver and whether the tumour has spread to the lungs. Most hepatoblastomas and some hepatocellular carcinomas produce alpha-fetoprotein (AFP) which can be measured in the blood. If the AFP is raised it can be used to monitor response to treatment. A biopsy of the tumour will be necessary to confirm the diagnosis before treatment is commenced. Blood tests are taken to measure kidney and liver function. (Refer to section on tests and procedures)

Treatment

Chemotherapy is used initially to reduce the size of the tumour to enable it to be surgically removed. The size and extent of the tumour will determine how much chemotherapy is to be given, but treatment is usually continued for 6 months.

Follow up care

Follow up care involves regular clinical examinations, blood tests to measure the level of AFP as well as scans and chest x-rays. After the first few years the focus of follow up changes to monitoring growth and development and other possible later side effects of treatment.