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The pyramid-shaped liver is the largest organ in the body. It is located under your right ribs, and it has two sections called lobes.
It is different from other organs because its blood comes from two sources. The hepatic artery brings in oxygen-rich blood, while the portal vein supplies nutrient-rich blood from the intestines.
Some of the liver's important jobs are to:
- Break down and store nutrients from the intestine
- Make clotting factors to help your body stop bleeding
- Create bile to help the intestine absorb nutrients
- Help get rid of waste
If liver cancer spreads, the most likely places are surrounding tissues, the lungs or the brain.
Types of childhood liver cancer
The two most common types of liver cancers in children are:
- Hepatoblastoma. This occurs most frequently in infants or young children between the ages of 2 months and 3 years. It is the most common kind of cancer of the liver in children.
- Hepatocellular carcinoma (HCC). It occurs most frequently in children between the ages of 10 and 16 years.
If your child has been diagnosed with liver cancer, we’re here to help. Call 888-352-4094 to make an appointment or request an appointment online.
Childhood liver cancer risk factors
Anything that increases your child’s chance of getting liver cancer is a risk factor.
- Certain conditions passed down in families, including Beckwith-Wiedemann syndrome and Familial adenomatous polyposis
- Low birth weight (less than 3½ pounds)
- Prior hepatitis infection
Not everyone with risk factors gets liver cancer. However, if your child has risk factors, you should discuss them with your doctor.
In rare cases, liver cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our genetic testing page to learn more.
Finding liver cancer early increases the chances of successful treatment. Symptoms vary from child to child. Often, liver cancer causes a mass, or bump, in the abdomen with no other symptoms. In many cases, it is found during a routine medical examination or by the parent.
Occasionally, pediatric liver cancer has other signs, which may include:
- Weight loss
- Loss of appetite
- Stomach pain
- Unequal growth of one part of the body compared to another
- Early signs of puberty
Liver cancer is rare, and these symptoms usually do not mean your child has liver cancer. However, it is important to discuss any symptoms with your doctor, since they may signal other health problems.
Our specialized pathologists are highly experienced in pinpointing the disease, which can make a difference by increasing the likelihood of successful childhood liver cancer treatment. They have at their fingertips the most detailed imaging tools, including precise triple-phase CT scans.
If your doctor is concerned your child may have liver cancer, the first step is a thorough physical examination. The doctor also will ask you questions about your child's health and your family medical history.
One or more of the following tests may be used to find out if your child has liver cancer and if it has spread. These tests also may be used to find out if treatment is working.
Blood tests, including alpha-fetoprotein (AFP) levels, may be used to test for liver cancer.
Imaging tests, which may include:
- CT or CAT (computed axial tomography) scans
- MRI (magnetic resonance imaging) scans
- PET (positron emission tomography) scans
- Angiogram, which makes liver blood vessels visible with an X-ray
A sample of tissue from the tumor or the healthy part of the liver is removed and looked at with a microscope. Healthy tissue may be tested to see how well the liver is working. A biopsy may be done by:
- Fine needle aspiration (FNA): A thin needle is inserted into the liver to remove a small amount of tissue.
- Core biopsy: This is similar to FNA, but a thicker needle is used to remove small cylinder-shaped samples (cores).
- Laparoscopy: A small incision (cut) is made in the abdomen, and a thin, lighted tube (laparoscope) is inserted to view the tumor and remove a small amount of tissue.
- Surgical biopsy: Tissue is removed during an operation.
Getting a second opinion at MD Anderson
The experts at Children’s Cancer Hospital are highly specialized in diagnosing and staging childhood liver cancer. We welcome the opportunity to provide second opinions. If you would like to get a second opinion at MD Anderson, call 888-352-4094 to make an appointment or request an appointment online.
Your child is the focus of a team of the world's leading pediatric liver cancer experts at MD Anderson's Children's Cancer Hospital. This dedicated group delivers personalized care using the most-advanced therapies with the least impact on your child's body.
Complex surgery is the main treatment for pediatric liver cancer. The surgeon must have a high level of skill for it to be successful. It is important to remove as much of the tumor as possible, while not harming nearby organs and tissue.
Liver cancer surgery has the best outcome when it is done by a surgeon who performs a large number of these procedures. As part one of the nation's largest cancer centers, Children's Cancer Hospital surgeons have exceptional levels of experience.
At Children's Cancer Hospital, your child benefits from some of the most innovative treatments available for liver cancer. Many of them are available at only a few centers in the world. We are actively researching new therapies for pediatric liver cancer, and we offer clinical trials of innovative agents.
If your child has liver cancer, we're here to help. Call 888-352-4094 to make an appointment or request an appointment online.
Our childhood liver cancer treatments
Your child’s treatment will be carefully planned by a team of doctors. They will talk to you about the best treatment for the cancer. This may depend on:
- If the tumor can be removed completely by surgery
- What type of cells are in the tumor
- If the cancer has spread
- The level of alphafetoprotein (AFP) in the tumor
Hepatoblastoma and hepatocellular carcinoma are treated differently. Both require complete surgical removal for treatment to be successful. Hepatoblastoma responds well to chemotherapy, but hepatocellular carcinoma tumors are usually treated with surgery alone.
Surgery is almost always part of the treatment for pediatric liver cancer. If all or most of the cancer can be surgically removed, the possibility of successful treatment is better.
Unfortunately, the surgeon may not be able to remove all of the tumor if it is large or has spread to other parts of the liver or the body. If this is the case, the surgeon will remove as much of the tumor as possible while keeping enough of the liver to function.
Since the liver helps with blood clotting, bleeding after surgery may be a problem. And, since the remaining liver still is damaged, the cancer may come back.
The main types of surgery for liver cancer are:
- Liver transplant: After the liver is surgically removed, it is replaced by a healthy donor organ. Liver transplant has a risk of serious infection and other health issues.
- Partial hepatectomy: The part of the liver where the tumor is located is removed surgically
- Tumor ablation: Heat (radiofrequency ablation) or extreme cold (cryosurgery or cryotherapy) is used to freeze or burn away the liver cancer. Ablation may be used when surgical removal of the tumor is not possible.
Tiny pellets of plastic or another material are injected into the arteries that carry blood to the tumor. The pellets block blood flow, which makes it harder for liver cancer to grow.
Because radiation may destroy normal liver tissue as well as cancer cells, it can be used only in low doses for liver cancer. Radiation therapy cannot cure liver cancer, but it may be used to shrink the tumor or relieve pain.
New radiation therapy techniques and remarkable skill allow MD Anderson doctors to target tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.
The Proton Therapy Center at MD Anderson is one of the largest and most advanced centers in the world. It’s the only proton therapy facility in the country located within a comprehensive cancer center. This means this cutting-edge therapy is backed by all the expertise and compassionate care for which MD Anderson is famous.
Proton therapy delivers high radiation doses directly to the liver cancer tumor site, with minimal damage to nearby healthy tissue. For some patients, this therapy results in a higher chance for successful treatment with less impact on the body.
Chemotherapy is often used to treat hepatoblastoma, but hepatocellular cancer doesn’t respond to it. Our experts also are working on new ways to give chemotherapy drugs directly into the liver, delivering higher doses of drugs than usually possible with fewer side effects. These include:
- Chemoembolization: A needle is inserted into an artery in the groin, and then a tiny tube is threaded into an artery leading to the liver. A high dose of medicine then is given. Afterward, the artery is blocked to prevent it from feeding blood to the liver.
- Hepatic artery infusion: A catheter (tube) is placed in the liver. Drugs are infused into a special implanted pump that delivers them continuously.
Children’s Cancer Hospital is among just a few cancer centers in the nation that are able to offer targeted therapies for some types of pediatric liver cancer. These innovative new drugs stop the growth of cancer cells by interfering with proteins and receptors or blood vessels that supply the tumor with what it needs to grow.
Why choose MD Anderson for your childhood liver cancer treatment?
At the Children’s Cancer Hospital, we have extraordinary expertise in all types of pediatric liver cancer. And we have designed everything about our hospital especially for children and teens.
Your child’s care will be customized by a team of experts, including medical, surgical and radiation oncologists and specialized pathologists. A specially trained and focused support staff includes nurses, physician assistants, therapists and many others. They all collaborate and communicate frequently about your child’s case. This translates into comprehensive, focused care for children and teens with liver cancer.
Our physicians have at their fingertips the most modern techniques and technology to diagnose and treat pediatric liver cancer. And they use them with extraordinary skill.
Surgery for liver cancer often is complex and challenging. Your best chance for a successful outcome is with a surgeon who has a deep level of experience and skill in these highly specialized procedures.
Our pediatric surgeons use the latest methods to perform a large number of delicate liver cancer surgeries each year, with higher chance for successful treatment than many other cancer centers.
Children’s Cancer Hospital offers clinical trials for innovative new treatments for pediatric liver cancer. Behind the scenes, we are working on groundbreaking basic science research to change the future of pediatric cancer.
Treating the whole child
Children’s Cancer Hospital is focused on children, with a full range of services and amenities that help make the child and family’s experience as comfortable as possible. We go beyond medical care to deliver a comprehensive experience that treats the whole child.
And at Children’s Cancer Hospital, you’re surrounded by the strength of one of the nation’s top cancer centers.
If your child has been diagnosed with liver cancer, we’re here to help. Call 877-632-6789 to make an appointment or request an appointment online.
Cancer has caused us to focus on all the things we have to be thankful for and to actively seek them out.
Vickie Gibson Poe