Hepatoblastoma in Children: Symptoms, Diagnosis and Treatments

What is it? It is liver cancer and a low condition in children.

According to St. Jude Children’s Hospital, it is estimated that 0.9 per 1 million children suffer from this condition. Hepatoblastoma is diagnosed more frequently in children from infancy to approximately three years.

Many cases of hepatoblastoma were first observed as an abdominal mass that parents or a doctor discover while bathing or examining the child.

Signs and symptoms

Hepatoblastoma usually presents as a knot in the stomach. Other symptoms include:

  • Little appetite
  • Weightloss.
  • Lethargy.
  • Fever.
  • Vomiting
  • Jaundice.

Diagnosis of Hepatoblastoma

You need to perform some tests to find out as much as possible about the tumor type, position, and size.

This will help to decide on the best treatment for the child. The tests will include:

Blood sample – hepatoblastoma often produces alpha-fetoprotein (AFP) released into the bloodstream.


This is generally referred to as a tumor marker and is used to control the response to treatment.

Chest x-ray – this is to discover if the tumor has spread to the lungs.

Ultrasound – will indicate the position and size of the tumor. Ultrasound may also be used to monitor the response to treatment.

Computed tomography or MRI scan – an MRI or CT scan of the abdomen and exploration of the child’s lungs will be done.

This will give more detailed information about the tumor and show if it has spread.

Biopsy – this is a small operation, usually carried out under general anesthesia. The surgeon will remove a small piece of tumor tissue, which will help get a specific diagnosis.


Staging measures the extent to which the tumor has spread beyond its original site. For treatment purposes, there are two groups. These are “standard risk” and “high risk”:

Standard risk – is when the tumor is confined to the liver and has infected most of the three liver segments.

High risk – is when the tumor affects all four segments of the liver and cancer spreads outside the liver.

Treatment of hepatoblastoma


The surgery is carried out after the chemotherapy to reduce the tumor. The goal is to eliminate cancer, carried out by a liver specialist surgeon.

If it is impossible to remove the tumor entirely after chemotherapy is applied, liver transplantation may be considered.


Treatment with cancer drugs is used to destroy cancer cells. It is usually given by injections and drips into a vein (intravenously).

The type of chemotherapy can vary in intensity and duration according to the risk group of the tumor.

If the child participates in a clinical trial, the treatment is explained in more detail in the datasheet of the specific problem. A ‘ road map will give an outline of the treatment.’

Clinical trials

Clinical trials are medical research studies in patients that are carried out to find new and better treatments.

In cancer, clinical trials are most commonly used to improve different forms of treatment such as surgery, radiotherapy, or chemotherapy.

The treatment that is being tested can be directed to:

Improve the number of people cured (for example, trying new types of surgery or chemotherapy).

  • Improve survival
  • Alleviate the symptoms of cancer.
  • Relieve the side effects of treatment.
  • Improve the quality of life or the sense of well-being of people with cancer.

Clinical trials may also involve research to understand more about the biology of the tumor.

You may be asked to allow us to research the tumor sample removed during surgery or on blood samples.

General side effects of chemotherapy

Bone marrow suppression (myelosuppression)

Chemotherapy drugs decrease the production of blood cells in the bone marrow for a variable period.

This results in a low level of red blood cells (anemia), low white blood cells (neutropenia), and platelets (thrombocytopenia).

The child may need blood transfusions or platelets and is at a higher risk of infections.

Nausea and vomiting

Some of the chemotherapy drugs can make the child feel sick or vomit.

Also, the doctor will prescribe medication to stop nausea and vomiting. These are generally very effective.

Mouth pain (mucositis)

Some chemotherapy drugs cause the mouth and throat lining to ulcerate and cause pain.

Hair loss

Long-term effects of treatment

A small number of children can develop side effects many years later because of their treatment.

These may include hearing problems, heart problems, kidney function, and a small risk of developing a second hepatoblastoma later.