Causes and risk factors
The liver cells undergo an abnormal and uncontrolled proliferation, eventually these clusters of cells lead to formation of a tumor or mass. However, this is a type of cancer which is restricted to the liver itself and it does not spread. The mystery behind these changes still remain unknown. Studies, experiments, and re-experiments have helped to put forth certain predisposing factors towards development of hepatoblastoma. Children suffering from other genetic condition are at high risk for developing this cancer. Familial adenomatous polyposis, Beckwith-Wiedemann syndrome are a few of the risk factors.
Clinical presentation:
The parents usually come up complaining that they are noticing a change in the weight in their kid and that the kid often has issues regarding food. Improper intake of food is seen. Early changes of puberty occurs in such children. Due to vomiting and pain in abdomen, the child becomes irritable and cranky. On examining the abdomen, a palpable mass on the right side is felt. Yellowish discoloration of the skin and mucous membrane along with sclera is noticed. General itching, fever and diarrhea are other symptoms associated. The right lobe of the liver is more commonly seen; in 15-20% of cases bilateral lobe affection is seen.
Investigations:
After complete history taken from the parents and the examination carried out by the pediatrician, certain investigations are carried out. Abdominal x-ray, USG, CT scan, or MRI of the abdomen is done. On detection of any abnormality, particularly an enlargement, mass, or tumor biopsy is advised. Blood test for tumor markers which show high levels of beta HCG and AFP is done along with liver function test and routine blood test.
Treatment:
Staging of cancer, (i.e., advancement and spread of pathology) is the essential tool for formulating the treatment plan. If any abnormal mass is detected, surgical excision of the tumor along with removal of the cancerous part of liver is done. Radiation treatment is used prior to surgical resection. Chemotherapeutic agents are prescribed.
Recent update:
Studies have suggested that a new chemotherapeutic agent “irinotecan” is effective in treating the hepatoblastoma; however, testing is still to be carried out.
Facts and figures:
The incidence of hepatoblastoma is 0.9 per 1 million children.
