Hepatoblastoma is a very rare liver cancer (malignant tumor) that affects babies and toddlers ages 1 to 3. It’s treated with surgery. Rarely, hepatoblastoma may spread outside children’s livers. Hepatoblastoma may be “cured” with chemotherapy to shrink cancerous tumors and surgery to remove sections of the liver affected by cancer.
Hepatoblastoma (pronounced “hep-ah-to-blas-to-mah”) is a very rare liver cancer that typically affects children ages 1 to 3. Surgeons may be able to cure hepatoblastoma if it’s diagnosed when liver cancer tumors are small enough to be completely removed with surgery. Medical researchers are evaluating ways to treat hepatoblastoma that surgery can’t remove or that’s spread (metastasized).
Hepatoblastoma is very rare. A global study estimates it affects 1 to 2 in 1 million children.
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Hepatoblastoma develops over time. If your child has hepatoblastoma, you may not notice any changes in your child’s body until the tumor in their liver has grown large enough to affect their overall health or behavior. Common symptoms include:
Medical researchers haven’t identified the exact cause, but they have pinpointed some risk factors, including certain genetic (inherited) conditions. Risk factors include:
Hepatoblastoma may spread (metastasize) to other areas of your child’s body, particularly to their lungs.
Healthcare providers use several tests to diagnose hepatoblastoma. Those tests include:
Tests are essential. But needles can sting and MRI machines make loud, scary noises, so it makes sense if your child becomes tearful or upset before or during tests. Talk to your child’s healthcare provider. They may recommend you work with a child life specialist to help you and your child. Here are some ways you can make essential tests easier:
Many healthcare providers use a process called pre-treatment extent of disease (PRETEXT) to stage or evaluate your child’s condition so they can create a surgical treatment plan.
Your liver has two lobes. Providers who use PRETEXT to stage hepatoblastoma divide the two lobes into four sections, or groups. Each group is based on the number of liver sections with tumors. The more sections with tumors, the higher the group number.
Under the PRETEXT system, providers establish a stage for the tumor in your child’s liver by treating them with chemotherapy before surgery. Chemotherapy may eliminate some tumors and shrink others, enabling providers to remove entire tumors, essentially eliminating the cancer.
For example, if your child has two tumors in two different sections of their liver, providers may say your child has a Group II cancer. But if pre-surgery chemotherapy eliminated one of the tumors so there’s a tumor in one section only, your child’s condition would be classified as a Group I cancer.
Healthcare providers typically treat hepatoblastoma with partial hepatectomy, removing the parts of your child’s liver that have tumors. They may combine surgery with the following treatments:
All treatments may have some immediate side effects that vary based on the kind of treatment, your child’s overall health and how they react to treatment. Some treatments may cause late effects. Late effects are health issues that appear months and years after your child completes treatment.
Healthcare providers may recommend additional surgery to remove tumors that spread from your child’s liver to other areas of their body.
Medical researchers don’t know exactly what causes hepatoblastoma, so they can’t say what prevents it. They do know there are some risk factors that may increase your child’s risk of developing the condition.
If you’re worried your child may be at risk, ask their healthcare provider for help. Depending on your child’s situation, their provider may recommend imaging tests and blood tests every three months until your child is 4 years old. (Children at risk of hepatoblastoma typically develop symptoms between ages 1 and 3.)
Yes, but it depends on when your child is diagnosed and receives treatment. Many times, healthcare providers can use surgery to remove smaller tumors that were diagnosed early on, before the tumors could grow larger, and spread to other parts of your child’s liver or other parts of their bodies.
Sometimes, children treated with partial hepatectomy develop new tumors in the same area as their original tumor. This isn’t common. When hepatoblastoma comes back, providers may use the same sorts of treatment that eliminated the first tumor. They may also recommend your child participate in a clinical trial.
Unfortunately, many children develop additional cancers later in life. Talk to your child’s healthcare provider about any additional cancers your child may develop. They may recommend setting up regular screening tests to detect new cancers and treat those cancers before they take hold. Providers also screen for long-term side effects from chemotherapy or surgery.
As each child’s situation and treatments are different, ask your healthcare provider what you may expect, including specific late effects your child may have. They’ll have suggestions for monitoring your child’s health and well-being.
Your child should have regular follow-up appointments so their provider can monitor their overall health and look for signs of returning hepatoblastoma, a new cancer or late effect health issues.
Hepatoblastoma treatment typically involves surgery. Surgery can have complications, including infection. You should take your child to the emergency room if they:
Hepatoblastoma is a very rare liver cancer. Here are some questions you may want to ask.
A note from Cleveland Clinic
Hepatoblastoma is a very rare liver cancer that affects 1 in 1 million babies and toddlers. If your child is that one in a million, you’re probably dealing with a whirl of emotions. You may be worried and afraid your child. You may feel overwhelmed, trying to stay calm on the outside while you’re crumbling on the inside. It may help to know many children are “cured” after surgery to remove cancerous liver tumors. It may also help to know your child’s care team understands what you’re going through. They’ll always be willing to explain what you can expect. They’ll be there for you and for your child, from diagnosis to treatment and beyond.
Last reviewed by a Cleveland Clinic medical professional on 03/10/2023.
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