What you need to know about liver tumors in children

Young boy in hospital for liver tumor treatment
Ziad was treated for hepatocellular carcinoma by a team at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. “It is exceedingly rare for hepatocellular carcinoma to occur in a child of Ziad’s age,” says Dr. Allison O’Neill.

Pediatric liver tumors are rare, comprising only 1 percent of all childhood cancers. There are two main types of liver tumors in children:

  • Hepatoblastoma: This type of tumor is typically diagnosed at age 3 or younger. The cause is unknown.
  • Hepatocellular carcinoma: This type of tumor is typically diagnosed in teens and young adults. The majority of hepatocellular carcinoma cases in young people occur in completely healthy livers, for reasons we can’t determine. Twenty percent of these cases are caused by underlying liver disease, whether it be a structural abnormality, metabolic irregularity or autoimmune condition.

Symptoms

Symptoms vary based on the tumor and the child’s age and ability to relay their symptoms to an adult. But there are some common symptoms that parents should be aware of:

  • distended (swollen) belly
  • firm mass in right upper quadrant of belly
  • irritability or crying out of proportion to physical exam findings
  • poor appetite or weight loss
  • fever

Treatment

We have so many exceptional experts in surgery, pathology, radiology, interventional radiology, liver transplant and research that come together to provide the best opportunities for enhanced care of our patients. I’m a huge proponent of a multidisciplinary team … it’s the best way to care for kids and unique to the Liver Tumor Program at Dana-Farber/Boston Children’s.

Surgery is a necessary component of treatment, and depending on the diagnosis, chemotherapy or other medical therapies must also be utilized. We may recommend:

  • surgery, including the possibility of a liver transplant or multi-organ transplant
  • chemotherapy or other medical therapies
  • interventional radiology, which delivers focal therapy directly to the tumor
  • enrollment in a clinical trial, which offers an organized approach to trialing new therapies or experimental therapies, such as immunotherapy, for advanced disease

Research

Though there is currently very little understanding of why these tumors occur, research efforts are underway to better understand genetic conditions linked to their development. Ongoing research efforts include:

  • genomic tumor profiling to try and determine which genes are responsible for tumor growth
  • efforts aimed at growing liver tumors in culture plates in the lab or in mice so as to study new therapies
  • a liver tumor registry that will allow collection of data from all patients currently being treated so as to assist us in treating patients years down the road

For a deep dive on research and treatment for pediatric liver tumors, watch Dr. O’Neill in this Facebook Live recording from April, 2018.

About the author: Dr. Allison F. O’Neill is a pediatric oncologist and the director of the Liver Tumor Program at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.