Introduction

Tumours of the liver in infancy and childhood are comparatively rare and account for only 4 to 5% of all paediatric solid tumours. Most liver tumours in children are hepatocellular carcinoma or hepatoblastoma. Hepatocellular carcinoma is strongly associated with previous hepatitis B virus infection. The prognosis after surgical removal of the tumour depends largely upon the type of liver cancer and extent of disease at diagnosis.

Symptoms

The usual initial feature is abdominal distension, and the enlarged liver bearing the tumour can be felt by the doctor. Pain is relatively uncommon. Loss of appetite, vomiting, anaemia, fever and yellow colouring of the eyes are usually associated with advanced ailment.

Diagnostic Tests

An X-ray of the abdomen will show an enlargement of the liver. An ultrasonogram will then show the location and the size of the tumour and the patency of the blood vessels supplying the liver. A computerised tomography (CT) scan is also useful in this respect. An angiography is another useful procedure for examining the liver before an operation is contemplated. Alpha-fetoprotein (AFP) level in the blood is usually elevated.

Treatment and Prognosis

Anticancer drugs can reduce the size of the tumour. But surgical removal of the tumour is the definitive therapy at present. Cure of liver tumour is possible only when complete excision has been achieved. The prognosis for hepatocellular carcinoma is poorer as these tumours are usually multiple in number, making complete surgical removal difficult or impossible. It also has a high recurrence rate.