Hepatoblastoma - Symptoms, causes and treatment

Health

Hepatoblastoma is liver cancer that occurs in children. Although it can affect adults, hepatoblastoma is more common in children.   

Children with hepatoblastoma may experience symptoms in the form of abdominal discomfort, fatigue, and loss of appetite. Please note, this disease is rare.

Causes of Hepatoblastoma

The exact cause of hepatoblastoma is not known, but there are several factors that can increase the risk of liver cancer in children, including:

  • Premature birth
  • Low birth weight
  • Hepatitis B infection
  • Biliary atresia

In addition, there are several genetic disorders that can also increase the risk of hepatoblastoma, namely:

  • Beckwith-Wiedemann syndrome
  • Hemihyperplasia
  • Familial adenomatous polyposis
  • Aicardi Sindrom syndrome
  • Simpson-Golabi-Behmel . syndrome
  • Edward's syndrome or trisomy 18
  • Glycogen storage disorders

Symptoms of Hepatoblastoma

Symptoms of hepatoblastoma are usually only realized when the tumor gets bigger. The most easily recognized symptom in children is the appearance of a painful lump in the abdomen. There are several complaints that are often not realized as a symptom of liver cancer in children, including:

  • Fever
  • Nauseous
  • Throw up
  • Loss of appetite
  • Jaundice
  • Swelling of the stomach
  • Drastic weight loss
  • Early puberty in boys
  • The appearance of blood vessels in the stomach

When to go to the doctor

If your child shows symptoms of hepatoblastoma, an examination must be done immediately so that the child can get treatment as soon as possible.

Regular check-ups to the pediatrician are also necessary if your child was born prematurely or was born with a low birth weight. Children who suffer from genetic disorders, such as Beckwith-Wiedemann syndrome, hemihyperplasia, Simpson-Gobali-Behmel syndrome, or trisomy 18, are also advised to regularly consult a pediatrician.

Ultrasound examination and examination alpha-fetoprotein (AFP) will also be performed periodically in children suffering from Beckwith-Wiedemann syndrome or hemihyperplasia. This examination is done to detect liver cancer in children early.

Children suffering from hepatoblastoma need to have regular check-ups with a pediatrician or pediatric gastro-hepatologist after treatment, to anticipate a recurrence of the disease.

As a preventive measure, obey the doctor's recommendations regarding mandatory immunization for children, especially immunization for hepatitis B which is a risk factor for hepatoblastoma.

DiagnosisHepatoblastoma

To detect liver cancer in children, the doctor will first ask the child's symptoms and medical history, and examine the condition of his stomach.

Then the doctor will perform additional examinations which include:

  • CT scan or MRI, to get a detailed picture of the liver. This procedure can also help doctors to determine the position of the tumor, tumor size, and spread.
  • Liver function tests, to determine liver health conditions.
  • Inspection alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-hCG), which may be elevated in the presence of hepatoblastoma.
  • Complete blood count, to see the picture of blood cells that can change when there is impaired liver function.
  • Biopsy or examination of tissue samples, to determine the type of tumor.

Stadium

After the child is known to have hepatoblastoma, the doctor will determine the stage of the disease. The stage of hepatoblastoma is determined based on the location of the tumor in the liver which is divided into 4 side areas, namely:

Stage I

In stage I, the tumor is located in the outermost area of ​​the liver.

Stage II

In stage II, the tumor is found in 2 liver areas or in 1 liver area flanked by 2 normal liver areas.

Stage III

In stage III, the tumor is in 3 liver areas or in 2 liver areas, each adjacent to a normal liver area.

Stage IV

In stage IV, the tumor is present in all four areas of the liver.

TreatmentHepatoblastoma

There are several factors that determine the type of treatment for hepatoblastoma. These factors include tumor size, tumor biopsy results, stage, and tumor spread. are some of the procedures used to treat hepatoblastoma:

Operation

Surgical removal of the tumor is the main treatment for liver cancer in children. This procedure can prevent the return of hepatoblastoma cancer. Surgery is also often combined with other procedures, such as chemotherapy.

There are several types of surgery that can be performed, including:

  • Partial hepatectomy, which is the removal of the part of the liver where the tumor is.
  • Total hepatectomy with liver transplant, ie removal of the entire liver followed by transplantation of a healthy portion of the liver from a donor.

Chemotherapy

Chemotherapy can be done before or after surgery. Chemotherapy before surgery is done to reduce the size of the tumor to make it easier to remove during surgery. While chemotherapy after surgery is done to reduce the possibility of tumor recurrence after surgery.

Radiotherapy

According to research, radiotherapy has not been able to completely cure hepatoblastoma, even when combined with chemotherapy. However, radiotherapy is believed to have a role in treating inoperable hepatoblastoma.

Transarterial chemoembolization (TACE)

Procedure transarterial chemoembolization (TACE) is performed on children with hepatoblastoma that cannot be treated with surgery. This procedure can help reduce the size of the tumor.

ComplicationsHepatoblastoma

Hepatoblastoma can cause complications in sufferers, including:

  • Rupture of a hepatoblastoma tumor in the body. This condition can cause peritonitis and anemia.
  • Early puberty in children, due to increased hormones human chorionic gonadotropin (hCG).

In addition, complications can also arise due to side effects of liver cancer treatment in children. These complications include:

  • Growth disorders.
  • Changes in mood, feelings, thinking, learning and memory.
  • The emergence of other types of cancer, besides hepatoblastoma.

PreventionHepatoblastoma

Premature births and babies with low birth weight are at risk of developing hepatoblastoma. Preventing premature birth or low birth weight babies, by maintaining a healthy pregnancy, can reduce the risk of liver cancer in children. To maintain a healthy pregnancy, pregnant women can do the following:

  • Maintain nutritional intake with balanced nutrition during pregnancy

    Make sure all the food consumed by pregnant women contains sufficient carbohydrates, protein, fat, vitamins, and minerals. If needed, pregnant women can take supplements according to the advice of a gynecologist.

  • Drink water White enough every day

    Drinking eight glasses of water per day is highly recommended for pregnant women. However, the amount of water intake can be increased according to the activities carried out. Try so that the body does not become dehydrated.

  • Perform routine pregnancy check-ups to the obstetrician

    To maintain the health of the fetus, pregnant women need to have regular check-ups with the obstetrician, which is once a month until 28 weeks of pregnancy, every 2 weeks until 36 weeks of pregnancy, then once a week until delivery.

  • Don't smoke and don't use drugs

    Smoking and using drugs during pregnancy are at risk of causing problems in pregnancy and childbirth.

Hepatitis B can also cause liver cancer in children. To prevent hepatoblastoma due to hepatitis B, you should adhere to the routine schedule of childhood immunizations. Hepatitis B immunization is given at birth, and when the child is 2, 3, and 4 months old.

In addition to children, adults also need to get hepatitis B vaccine if they are at risk of contracting it, for example workers in the health sector (doctors, nurses, or laboratory workers).