What is Hepatoblastoma?Heptoblastoma is a rare childhood malignant liver cancer. Hepatoblastoma cells resemble fetal liver cells, mature liver cells, or bile duct cells. Malignant cancer is a cancer that grows and spread rapidly to the other parts of the body.
Disease Etiology (Causes)The reason is unknown. However, certain genetic mutations (gene changes) and the presence of risk factors, such as low birth weight, trisomy 18, Li-Fraumeni syndrome and neurofibromatosis, are risk factors that can cause heptoblastoma.
Disease EpidemiologyAlthough hepatoblastoma is a rare cancer, it is the most common cancer in children. The disease usually affects children under 3 years of age. It accounts for approximately 79% of all liver tumors in children. The annual incidence of hepatoblastoma in children under 1 year of age is 11.2 cases per million. Clinical surveillance data showed that reported cases of hepatoblastoma were significantly higher in underweight infants. It is more common in white children than in blacks. It is also more common in boys and babies than in girls.
Signs and SymptomsTypically, hepatoblastoma is diagnosed as a mass in the abdomen with no specific signs or symptoms or no signs or symptoms at all. However, in some cases following signs and symptoms can be observed. These are
- Loss of appetite in advance cases of hepatoblastoma
- Defect in heart valves
- Abnormal kidney function and shape in syndromic children
- Cleft palate
- Dysplasia (the presence of abnormal cells that may or may not be cancerous) of the earlobes.
- Meckel diverticulum
- Bone pain
- Pain in abdomen
- Symptoms of anemia such as, difficulty in breathing, pale skin and eyes, constant exhaustion and fatigued
DiagnosisThe following diagnostic tests and procedures can be used to make a diagnosis.
- CBC ( Complete blood count with peripheral smear)
- Serum alpha fetoproteins
- Liver enzyme levels
- Blood coagulation profile (for example partial thromboplastin time PTT, international normalized ratio INR)
- Serum electrolyte levels
- Liver function tests (LFTs)
- Abdominal USG, CT-scan and MRI
- Immuno-histochemical staining
- Liver Biopsy
TreatmentThe selection of suitable treatment depends upon multiple factors like the size, number, and location of the tumor. Other factors are the overall performance of the liver or liver function, presence or absence of the spread of the tumor to other parts of the body, presence or absence of the Liver cirrhosis, its extent, and risk involved in the case of surgery due to extent of the cirrhosis. On behalf of the above-mentioned factors there are following treatment options;
- Resection; surgical removal of the tumor along with some healthy tissues from the surroundings of the tumor to stop the spread of cancer in the early stage of cancer.
- Radiofrequency Ablation; is a non-surgical technique to kill and to stop the spread of cancer cells in cases where surgery is not a suitable option.
- Targeted immunotherapy
- Liver Transplantation: it is a surgical procedure through which a diseased liver is replaced by a healthy liver from a donor.