In this section
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
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.
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
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 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.