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Childhood Liver Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - General Information About Childhood Liver Cancer

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This summary is about the treatment of primary liver cancer (cancer that begins in the liver). Treatment of metastatic liver cancer, which is cancer that begins in other parts of the body and spreads to the liver, is not discussed in this summary. Primary liver cancer can occur in both adults and children. However, treatment for children is different than treatment for adults. See the PDQ summary on Adult Primary Liver Cancer Treatment for more information.

Certain diseases and disorders can increase the risk of developing childhood liver cancer.

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your child's doctor if you think your child may be at risk.

Risk factors for hepatoblastoma include the following:

  • Having familial adenomatous polyposis (FAP).
  • Having Beckwith-Wiedemann syndrome.
  • Having hemihyperplasia (a condition in which one side of the body or a part of one side grows faster than the other).
  • Having a very low weight at birth.

Risk factors for hepatocellular carcinoma include the following:

  • Being male.
  • Having the hepatitis B virus that was passed from mother to child at birth.
  • Certain genetic changes linked with childhood hepatocellular carcinoma.
  • Having one of the following conditions:
    • Biliary cirrhosis.
    • Alagille syndrome.
    • Glycogen storage disease.
    • Progressive familial intrahepatic disease.
    • Tyrosinemia.

Patients with tyrosinemia or progressive familial intrahepatic disease may receive a liver transplant before there are signs of cancer.

Possible signs of childhood liver cancer include a lump or pain in the abdomen.

Symptoms are more common after the tumor gets big. Other conditions can cause the same symptoms. Check with your child's doctor if your child has any of the following problems:

  • A painless lump in the abdomen.
  • Swelling or pain in the abdomen.
  • Weight loss for no known reason.
  • Loss of appetite.
  • Nausea and vomiting.

Tests that examine the liver and the blood are used to detect (find) and diagnose childhood liver cancer.

The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
  • Serum tumor marker test: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers. The blood of children who have liver cancer may have increased amounts of a hormone called beta-human chorionic gonadotropin (β-hCG) or a protein called alpha-fetoprotein (AFP). Other cancers and certain noncancerous conditions, including cirrhosis and hepatitis, may also increase AFP levels.
  • Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
    • The number of red blood cells, white blood cells, and platelets.
    • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
    • The portion of the blood sample made up of red blood cells.
  • Liver function tests: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver. A higher than normal amount of a substance can be a sign of liver cancer.
  • Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later. In childhood liver cancer, an ultrasound exam of the abdomen is usually done.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. In childhood liver cancer, a CT scan of the chest and abdomen is usually done.
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • Abdominalx-ray: An x-ray of the organs in the abdomen. An x-ray is a type of energy beam that can go through the body onto film, making a picture of areas inside the body.
  • Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. The sample may be taken during surgery to remove or view the tumor. A pathologist looks at the sample under a microscope to find out the type of liver cancer.

    The following test may be done on the sample of tissue that is removed:

    • Immunohistochemistry study: A laboratory test in which a substance such as an antibody, dye, or radioisotope is added to a sample of cancer tissue to test for certain antigens. This type of test is used to check for a certain gene mutation.
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