Radiation Oncology/Peds/Hepatoblastoma

• Uncommon malignant liver cancer occurring in infants and children and composed of tissue resembling fetal liver cells, mature liver cells, or bile duct cells • Originate from immature liver precursor cells, are typically unifocal, affect the right lobe of the liver more often than the left lobe, and can metastasize • Children who have familial adenomatous polyposis of the colon and rectum are high risk for hepatoblastoma • Usually present with an abdominal mass and most commonly diagnosed during a child's first three years of life • Alpha-fetoprotein (AFP) levels are commonly elevated • Surgical removal of the tumor, adjuvant chemotherapy prior to tumor removal, and liver transplantation have been used for treatment • Radiotherapy may be used when microscopic disease is seen at the resection margins (usually 1200-2000 cGy) • Primary liver transplantation provides high, long term, disease-free survival rate in the range of 80% • Presence of metastases is the strongest predictor of a poor prognosis