Radiation Oncology/Peds/Hepatoblastoma

• Uncommon malignant liver cancer occurring in infants and children and composed of tissue resembling fetal liver cells, mature liver cells, or bile duct cells

• Originate from immature liver precursor cells, are typically unifocal, affect the right lobe of the liver more often than the left lobe, and can metastasize

• Children who have familial adenomatous polyposis of the colon and rectum are high risk for hepatoblastoma

• Usually present with an abdominal mass and most commonly diagnosed during a child's first three years of life

• Alpha-fetoprotein (AFP) levels are commonly elevated

• Surgical removal of the tumor, adjuvant chemotherapy prior to tumor removal, and liver transplantation have been used for treatment

• Radiotherapy may be used when microscopic disease is seen at the resection margins (usually 1200-2000 cGy)

• Primary liver transplantation provides high, long term, disease-free survival rate in the range of 80%

• Presence of metastases is the strongest predictor of a poor prognosis