• Hepatocellular Carcinoma Overview

    Hepatocellular carcinoma, also called liver carcinoma, is a rare, aggressive type of liver cancer.   It is more frequently diagnosed in adults and is often seen in conjunction with underlying liver disease (for example, cirrhosis).  When diagnosed in pediatric patients, hepatocellular carcinoma is often sporadic but can be linked to hepatitis infection or genetic conditions.

    Hepatocellular Carcinoma Treatment at Dana-Farber/Boston Children's

    Patients with hepatocellular carcinoma are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through the Liver Tumor Program. Continue reading to learn more about hepatocellular carcinoma or visit the Liver Tumor Program homepage to learn about our expertise.

    Symptoms & Diagnosis

    The symptoms of hepatocellular carcinoma may vary, depending on the size and location of the tumor. Common symptoms include:

    • A large abdominal mass or a swollen abdomen
    • Pain on the right side that may extend to the back and shoulder
    • Back pain from compression of the tumor
    • Decreased appetite and weight loss
    • Vomiting
    • Jaundice
    • Fever
    • Itching skin
    • Anemia

    A child’s physician may order a number of different tests to diagnose hepatocellular carcinoma. In addition to a medical history and physical exam, these may include:

    • Blood tests, including a complete blood count and blood chemistries
    • Liver and kidney function tests
    • Alpha-fetoprotein, a protein often secreted by this type of tumor 
    • Liver ultrasound
    • Liver and chest computerized tomography (CT or CAT) scan
    • Liver magnetic resonance imaging

    Ultimately, the diagnosis is confirmed by a biopsy of the tumor. Hepatocellular carcinoma can spread to parts of the abdomen and the lung.  Therefore, a full work-up at diagnosis is necessary to define disease extent. After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care Options

    Surgery is the key treatment for hepatocellular carcinoma. Successful removal may be difficult, however, if there is tumor throughout the liver, metastases, or scarring/cirrhosis damaging healthy parts of the liver.

    Chemotherapy and radiation therapy are often used in conjunction with surgery; however, chemotherapy is not particularly effective against hepatocellular carcinoma.  A liver transplant may be considered for unresectable disease.

    There can be side effects related to the tumor itself or its treatment. Knowing what these side effects are can help a physician prepare for and, in some cases, prevent these symptoms from occurring.

    Progressive or Recurrent Disease

    The prognosis for children with progressive or recurrent hepatocellular carcinoma is poor.Clinical trials may be appropriate.

    Long-term Outlook

    Despite research efforts, hepatocellular carcinoma continues to have an unfavorable prognosis. Surgical resection is associated with improved survival rates; however, fewer than one-third of these tumors can be completely removed and they are much less responsive to chemotherapy than other tumor types.   Although chemotherapy and radiation therapy can be toxic to the body, even a temporary reduction in tumor size can improve a child’s quality of life.
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