Liver cancers in children

Introduction:

The liver is a large, very important organ situated in the right upper quadrant of abdomen. The normal functions of the liver in the body are:
To help store nutrients from food
To break down and remove harmful chemicals from the body
To build chemicals that the body needs to stay healthy

Hepatoblastoma: The most common type of liver cancer in children is Hepatoblastoma. it occurs most frequently in infants or very young children between 2 months and 2 year.

Symptoms:

• Lump in the abdomen (most common)



• Reduced appetite



• lethargy



• nausia / vomiting



• Pain in abdomen



• Jaundice

Investigations:

The following minima investigations are proposed to diagnose hepatoblastoma

• Tumor markers- serum AFP



• CT scan of abdomen with Ct guided FNAC or Biopsy



• X-ray chest



• Complete blood count



• Biochem profile

Treatment:

Surgery & chemotherapy are two tratment options

Surgery: Liver resection according to the location & extent of the tumor. It will be either

• Rt hepatectomy



• Lt hepatectomy



• Extended Rt or Lt hepatectomy



• Bi or trisegmentectomy

If liver resection is not possible because of multicentric disease then liver transplant is the only treatment of option.

Chemotherapy:
Chemotherapy is given before or after surgery. Surgery is done either as a sandwitch surgery (in between cycles of chemotherapy) or it is done at the start & then chemotherapy is given. Antitumor drugs dispersed in a lipid lymphographic medium are intraarterially administered unresectable hepatoblastoma.The more information about intra-arterial chemotherapy can be read in Rare Adult & Pediatric Cancer Web Blog

The drugs used are

• Cisplatin



• Doxorubicin



• Vincristine



• 5-Fluorouracil

Other less common malignant liver tumor in children:

Hepatocellular carcinoma.