Hepatoblastoma is the most common liver cancer in childhood. The etiology of hepatoblastoma is still unknown. Hepatoblastoma is closely related to genetic syndromes, suggesting that hepatoblastoma is a genetic predisposition.
Over the past decade, great strides have been made in understanding the etiology leading to hepatoblastoma, and several important genetic factors that appear to be important for the development and development of this tumor have been identified.
Hepatoblastoma caused by a hepatocyte precursor is the worst liver tumor among children. The clinical symptoms of hepatoblastoma are alpha-fetoprotein (AFP) and abdominal weight gain. Because of the shortage of hepatoblastoma, diagnosis and treatment face challenges.
Stages of Hepatoblastoma
The stages depends on the level of the liver involved and whether the tumor is present in only one area or if it is widespread. The most common areas of metastasis or tumor proliferation are the lungs and lymph nodes around the abdomen.
- Stage I; No tumor spread can be found outside the liver. The tumor is surgically removed at the time of diagnosis. The pathologist looks at the tissue removed under a microscope to see if the sides are exposed to cancer cells.
- Stage II; No tumor spread can be found outside the liver. The tumor is surgically removed at the time of diagnosis, but next to the removed tissue contains cancer cells.
- Stage III; The tumor cannot be surgically removed at the time of diagnosis because it is too large, has grown or suppressed important tissues in the liver, or has spread to lymph nodes from the liver. In stage III disease, the tumor cannot be found in other parts of the body.
- Stage IV; Swelling spreads through the blood to other parts of the body. It often spreads to the lungs.
Also there are two staging systems for hepatoblastoma.
The pre-treatment extent of disease (PRETEXT) staging system; This depends on the image of the liver before surgery is tested. There are four main parts of the liver. PRETEXT action depends on the number of lobes that have a tumor in them. For example, if one lobe is involved, the disease is called stage I. If all four lobes are involved, the disease is called stage IV.
The Children’s Oncology Group staging system; This is based on further images of other body parts, as well as the results of the surgery if performed during the examination. COG placement indicates how much swelling was removed, and how much swelling was spread.
Although the exact cause of liver cancer is unknown, there are a number of genetic conditions that are associated with a higher risk of developing hepatoblastoma. They include:
- Beckwith-Wiedemann syndrome; The disease is characterized by a combination of Wilms’ inflammation, kidney failure, reproductive system defects and thyroid defects.
- Familial adenomatous polyposis; This is a group of rare diseases of the gastrointestinal tract.
- Hemihypertrophy; This condition is the rapid growth of one organ on one side of the body compared to the other.
Children who are infected with hepatitis B infection at an early age, or those who have biliary atresia, are also at greater risk of developing liver cancer.
Symptoms of hepatoblastoma
Hepatoblastomas develop over time. You may not notice any changes in your baby’s body until the swelling in the liver is large enough to affect his or her overall health or behavior. Here are some signs that your baby may have hepatoblastoma;
- a large abdominal mass, or swollen abdomen
- weight loss, decreased appetite
- abdominal pain
- vomiting
- jaundice
- fever
- itching skin
- anemia
- back pain
The symptoms of hepatoblastoma are as numerous as those of many other medical conditions. Still, it is important to take your child to a health care provider if you notice these symptoms. Only a health care provider can determine if your baby has cancer.
Causes of hepatoblastoma
Researchers have not yet identified the exact cause of hepatoblastoma, but they have identified a few risk factors, including hereditary conditions. Here are some factors that may increase your child’s risk of getting hepatoblastoma:
- Premature birth; Most babies are born 37 weeks after their mothers become pregnant. A baby born before 37 weeks is considered premature.
Low birth weight. - Early exposure to Hepatitis B; This is a virus that attacks your baby’s liver.
- Biliary atresia; This condition affects infants, preventing bile from their small intestines. Supported gall bladder damage children’s liver.
- Hemi hyperplasia; This condition affects your baby’s body, causing one side of your baby’s body to be larger than the other.
Diagnosis
You can take your baby to a health care provider because of swelling, swelling, or pain in the abdomen, or other symptoms. Your healthcare provider will ask about your baby’s symptoms. She will examine your baby, focusing on the abdomen. Your baby may need to see a pediatric cancer specialist. Your child may have tests such as:
- Blood tests; These tests look for symptoms. They look for problems with blood clotting, liver and kidney function, tumor symptoms, genetic disorders, and more.
Ultrasound; Sound waves are used to create images. This may be one of the first tests used to check the liver. - CT scan; A series of X-rays and computers are used to create body images. This can be done to check the blood vessels in the liver.
- MRI; Large magnets, radio waves, and computers are used to create in-depth images of the inner body. This can also be done to check the blood vessels in the liver.
- Tumor biopsy; The tumor sample is taken with a microscopic scan of cancer cells. Biopsy is needed to diagnose hepatoblastoma. A biopsy can be performed by injection or by surgery.
After the diagnosis of hepatoblastoma, your child will receive other tests. These help your child’s health care providers learn more about cancer. They will show how much and how far the cancer has spread in your baby’s body.
Prevention of hepatoblastoma?
Researchers do not know all the reasons why certain children get hepatoblastoma, but they have identified possible connections between a few inherited conditions. They also believe that premature babies or those born with very low birth weight have a higher risk of developing hepatoblastoma.
Ask your child’s health care provider about the risk factors for hepatoblastoma. They will help you determine if your child is at risk. They will also make a plan to monitor your baby’s health for symptoms of hepatoblastoma. Early detection and treatment of hepatoblastoma increases your child’s chances of success.
Treatment of hepatoblastoma
If your child has been diagnosed with hepatoblastoma, you may want to have your child see another oncologist. This means getting a second opinion. Your insurance company may need a second opinion. Treatment will depend on the action and other factors. Cancer can be treated with any of the following;
1. Chemotherapy
These are medicine that kill cancer cells. They can be removed before or after surgery. They are given intravenously (IV) or by injection, or by mouth (oral). Medications can also be sent to the liver.
This is done through a catheter inside the main artery of the liver. This is called chemoembolization of the liver artery. The drug is mixed with a substance that inhibits blood flow to the tumor. This leads to complications with tumor growth.
These cancer cells may be too small to be detected by doctors. Infants and toddlers with COG stage I of a non-invasive type called pure fetal hepatoblastoma may not need chemotherapy. For all other infants and children, chemo is given before or after surgery.
2. Liver transplantation
Liver transplantation has also been used successfully with chemotherapy to treat hepatoblastoma. Liver transplantation is often used in cases where the tumor is located only in the liver and cannot be surgically removed.
In these cases, the tumor-induced liver is completely removed and replaced by the liver from donors. As with other hepatoblastoma surgery, chemo is used before and often after liver transplantation to control cancer.
In some cases, infants and children who have hepatoblastoma that cannot be removed by routine surgery and have cancer outside their liver, can still successfully transplant the liver. An example of when this may be possible is when the disease outside the liver goes away with the chemo.
3. Tumor removal or resection
Many factors are taken into consideration when checking to see if a tumor can be safely removed from a baby’s liver and leaving a normal enough liver. One of the things doctors look for is the level at which the liver is involved. For example, some children have one tumor, while other children have multifocal disease.
Some tumors involve one or two liver lobes, while others involve three or four liver lobes. Some tumors invade vital structures in the liver, while others do not invade such structures.
Tumor removal can be discussed in the diagnosis in patients with minor ailments at this stage. This is true for about a third of children with hepatoblastoma. Among children whose tumor is not detected at the time of diagnosis, their swelling may sometimes change after a few cycles.
4. Surgery
This can be done to take a tumor sample for diagnosis and it can be done to remove as much swelling as possible. Surgery can also be performed to remove swelling from other parts of the body, such as the lungs.
The most common treatment for hepatoblastoma and other liver tumors is surgery to remove the tumor. Prior to surgery, the baby may need chemotherapy to reduce the size of the tumor. Liver tissue has the ability to regenerate until it is the right size again.
Removal surgery is performed by our popular general pediatric surgery team, who each deals with less invasive techniques for removal of tumors whenever possible.
5. Radiation therapy
These are powerful X-rays or other types of radiation. Radiation is used to kill cancer cells or to stop them from growing. This is studied for use in the treatment of hepatoblastoma.
Health care providers can use radiation therapy after surgery to remove any remaining cancer cells or as an alternative to treatment that cannot be surgically removed.