Liver Tumors

Benign liver tumors are common and usually do not produce symptoms. Malignant tumors are less frequent and require more aggressive treatment. The most common cancerous liver tumors in children are:

• Hepatoblastoma. This cancer is seen most often in babies and children younger than 3. It usually does not spread beyond the liver.
• Hepatocellular carcinoma. This cancer can occur at any age but usually affects teenagers more than younger children. It appears in several different areas of the liver and often spreads to other places in the body.

Hepatoblastoma usually responds well to treatment when detected early. Hepatocellular carcinoma is much more difficult to treat and the long-term outlook (prognosis) is often poor.

Liver cancer is more common in boys than girls. Certain diseases and disorders can increase the risk of developing childhood liver cancer. Having one of these diseases or disorders does not mean that a child will develop cancer. These disorders include:

• Familial adenomatous polyposis (FAP). FAP is an inherited condition that causes polyps to form.
• Beckwith-Wiedemann syndrome. This is a genetic condition that causes excessive growth.
• Hemihyperplasia. This is a condition in which one side of the body grows faster than the other.
• Very low birth weight. A newborn weighing less than 3 pounds, 5 ounces is considered to have very low birth weight.
• Hepatitis B. Hepatitis B is passed from mother to child at birth.
• Familial cirrhosis. This is scarring of the liver due to genetics.
• Fanconi anemia. This is a condition of the bone marrow.

Often, no symptoms of liver tumors are seen until the tumor has become large.

Symptoms of a liver tumor can include:

• Precocious puberty
• Jaundice (yellowing of the skin and whites of the eyes)
• Loss of appetite
• Nausea and vomiting
• Painless lump in the abdomen
• Swelling or pain in the abdomen, especially on the right side where the liver is located
• Weight loss for no known reason

Many other conditions can cause the same symptoms, so it is important to check with your child’s doctor for an accurate diagnosis.

Diagnosis of Liver Tumors

Diagnosis of a liver tumor starts with a physical exam and medical history. Other procedures and tests performed by doctors at Riley at IU Health may include:

• Blood tests. These tests can be used to detect the presence of specific proteins (alpha-fetoprotein and beta-HCG) released by liver tumor cells in the blood, which may indicate the presence of a liver tumor. Other blood tests may be used to determine how well the liver is working or to monitor side effects from chemotherapy.
• Ultrasound. This exam uses sound waves to view tissues and organs inside the body.
• Computed tomography (CT) scan. A CT scan is a special X-ray that shows the inside of the body from several angles.
• Magnetic resonance imaging (MRI). This test uses magnetism to take detailed pictures of the inside of the body.
• Abdominal X-ray. This imaging test takes pictures of the structure of and organs in the abdomen.
• Liver biopsy. A biopsy is a small piece of tissue that is removed and viewed under a microscope for cancerous cells.