Hepatoblastoma

Key points

• Hepatoblastoma is a very rare childhood cancer of the liver
• It usually affects young children (less than 3 to 4 years old)
• If not treated, it can spread (metastasise) to other areas of the body, usually the lungs
• With treatment, more than 4 in 5 children with hepatoblastoma will get better.

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What is hepatoblastoma?

Hepatoblastoma is a type of liver cancer that is usually found in babies and children up to the age of 3 to 4. But it can happen in children of any age. It is very rare, (diagnosed in around 1 to 3 in every 1 million children) but it is the most common childhood liver cancer.

The success rate of treatment is excellent, with over 80% of children surviving long term.

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What are the symptoms of hepatoblastoma?

Hepatoblastoma usually shows as a firm swelling of the liver. This means a parent may see or feel a swelling or mass on the right-hand side of the child’s tummy, under the ribs.

Other signs and symptoms of hepatoblastoma can be different for every child. They can include:

• a swollen belly
• weight loss
• worse appetite
• vomiting
• jaundice
• itchy skin
• anaemia (low iron in the blood)
• back pain.

The symptoms of hepatoblastoma can be similar to many other conditions. If you are worried, it is very important to see your doctor so your child can be assessed.

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How is hepatoblastoma diagnosed?

If your doctor suspects your child may have hepatoblastoma, they will order some blood tests and an ultrasound of the abdomen (belly). The blood tests will check liver function and tumour markers (a blood test that checks for a special type of cancer level, which can be increased in hepatoblastoma). The ultrasound will show a lump in the liver.

Your child will also have scans such as a CT, MRI, PET scan or bone scan to check the size of the tumour and whether it has spread (metastasised) outside the liver.

The diagnosis will be confirmed with a biopsy of the tumour (where a small sample of liver is removed under anaesthetic to study in the laboratory).

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Why did my child get hepatoblastoma?

Because it is so rare, the exact cause of hepatoblastoma is not known.

There are some genetic conditions that have been linked to an increased risk of developing hepatoblastoma. These include Beckwith-Weidemann Syndrome, Familial adenomatous polyposis and Hemihypertrophy.

Hepatoblastoma is more common in children who were born very prematurely with very low birth weights.

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How is hepatoblastoma treated?

The aim of treatment is to remove all the hepatoblastoma or as much as possible by surgery and then back this up with chemotherapy. The type of surgery and chemotherapy depends on the stage of the cancer (how extensive it is and if it has spread outside of the liver). The treatments are listed below:

Surgery: this may be done to remove all of the tumour, or as much as possible. It can also be used to remove tumours that have grown outside the liver.

Chemotherapy: this may be given before and after surgery. It is usually given through a vein (intravenous). Chemotherapy will often be used to shrink the tumour before surgery or transplant, or as a treatment after surgery or transplant to ensure any remaining cancer cells are killed.

Liver transplant: If a hepatoblastoma occupies most of the liver, then the entire liver needs to be removed and your child may be referred for a liver transplant.

Radiation therapy: This is a type of treatment used to kill cancer cells or stop them from growing.

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Living with hepatoblastoma

Children with hepatoblastoma need ongoing care. There will be several specialists involved including an oncologist (specialist cancer doctor), surgeon and paediatric liver specialist if transplantation is required. Even after surgery or liver transplant, your child will require close follow up and monitoring.

If liver surgery has been done to completely remove the hepatoblastoma, your child will need follow up scans and blood tests for at least 5 years to monitor for the disease coming back.

If surgery, chemotherapy or radiation therapy have been done to treat disease outside the liver, your child will also continue to be monitored as above. There can also be complications from treatment such as chemotherapy (these can include infections, vomiting, hair loss, tiredness, problems with growth and development). If your child is undergoing treatment, you will be provided with information on what to expect and who to contact if you have concerns.

If your child has had a liver transplant, they will need lifelong medication and follow up to prevent rejection of their new liver.

Read about transplant

 

You can help your child in many ways:

Diet: if your child is having trouble eating, you can see a dietitian who specialises in children’s cancer

Tiredness: Your child will need to balance rest and activity. Encourage some exercise as this is good for overall health and may help to reduce tiredness

Emotional support: This will be provided by the cancer centre. It’s also important for you to keep up your own family and social contacts and look after yourself. The cancer centre may suggest a local counsellor or support group.

Appointments: Make sure you child attends all their appointments. Write down questions you have so you can talk to the healthcare team and get clear answers and instructions.

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More information

For more information, you can look at the sites below, but most importantly talk to your specialist about the best treatment for your child.

Nationwide Children’s

Cincinnati Children’s

Please note, some information provided on international websites may not be applicable in Australia.

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What next?

Although there are no dedicated hepatoblastoma support groups in Australia, there are extensive groups to support children and their families who are dealing with a cancer diagnosis.

Call 1800 841 118 to speak to a liver nurse.

Find a support group

Reviewed April 2025