Hepatocellular carcinoma

What is hepatocellular carcinoma?

Hepatocellular carcinoma is a rare cancer of liver affecting approximately 90 children in the US each year. It is the second most common type of liver cancer in children after hepatoblastoma. Among children older than five, it is the most common type of liver cancer. Children who have hepatocellular carcinoma are typically diagnosed when their parents or doctor notice an abdominal mass or fullness. Sometimes the tumor may cause weight loss, pain, nausea, vomiting, or jaundice (yellowing of the skin and eyes).

Who gets hepatocellular carcinoma?

Hepatocellular carcinoma is more likely to arise in a liver which has an underlying abnormality. Children with a prior history of biliary atresia, metabolic abnormalities such as tyrosinemia, galactosemia, familial cholestatic cirrhosis, giant cell hepatitis of infancy, Fanconi’s anemia, glycogen storage disease or anti-trypsin deficiency are at greater risk for developing hepatocellular carcinoma. 

How is hepatocellular carcinoma diagnosed?

Most children with a liver tumor will have an ultrasound as the initial imaging study. Computed tomography (CT) and magnetic resonance imaging (MRI) are the definitive diagnostic studies that provide precise anatomic detail, vascular information, and measurements of the tumors' size. At Texas Children’s Hospital, we have created novel imaging protocols for measuring tumor volume, vascular anatomy, and perfusion, which can be performed with free-breathing (without the need for endotracheal intubation and breath-holding).

How do you treat hepatocellular carcinoma?

Surgery to take out the entire tumor is the best treatment for hepatocellular carcinoma.

If the tumor cannot be removed by surgery and there is no evidence that the cancer has spread outside of the liver, the child may be evaluated for liver transplantation. During liver transplantation, the entire liver and tumor are removed and a new liver is put in to take the place of the old, diseased one. Learn more about liver transplantation for children with liver tumors. 

If the tumor has spread beyond the liver, it can be treated with chemotherapy; however, most times, hepatocellular carcinoma does not respond well to chemotherapy.