Disease Information

Solid Tumor: Hepatocellular Carcinoma

Alternate Names: None

Definition

Hepatocellular carcinoma is a cancer of the liver and usually occurs in a liver that has been chronically injured by an infection, a metabolic disease or various drugs.

Incidence

• Although hepatocellular carcinoma is the most common solid-organ tumor worldwide with at least 1 million new cases diagnosed annually, it is very rare in children.
• Hepatocellular carcinoma has an incidence of 0.7 per 1 million children and less than 1percent of hepatocellular carcinomas occur in patients before the age of 20 with the average age of onset between 12 and 14 years of age. 
• It is very rare in children under age 5.

Influencing Factors

• Children infected with hepatitis B or C (viral infections of the liver) are more likely than other children to get hepatocellular cancer.
• Immunization to prevent hepatitis B may decrease the chance of developing hepatocellular cancer.
• Some congenital diseases such as hereditary tyrosinemia, Wilson’s disease, type 1 glycogen storage disease, familial polyposis coli, ataxia telangiectasia, a-1 antitrypsin deficiency, Budd-Chiari syndrome, galactosemia, and hemochromatosis are associated with an increased risk.
• Drugs that have been associated with an increase risk include chronic ethanol use and prolonged use of androgenic anabolic steroids.

Clinical Features and Symptoms

• Abdominal distention and right upper quadrant mass are the most common symptoms.
• Abdominal pain occurs in half the patients, and nausea and vomiting are common.
• Fever, weight loss and anorexia may occur.

Survival Rates

• Cure is possible if the tumor can be completely removed by surgery.
• If the cancer has not spread outside the liver, sometimes cure can only be accomplished with a liver transplant from a donor.

Treatment Strategies

• Unfortunately, hepatocellular carcinoma does not respond well to any known chemotherapy.
• If the tumor cannot be removed, treatment with a medicine called sorafenib can slow the progression and improve survival, but usually only by about three months. Other alternatives include enrolling on an experimental protocol of a new medicine to see if the tumor will shrink.
• Alternatively, a needle can be inserted into one of the blood vessels that supply the tumor. Microscopic beads, with or without chemotherapy, are then injected to cut off the blood supply of the tumor. This is known as chemoembolization.
• Smaller tumors can sometimes be killed by inserting a needle directly into the tumor and injecting a chemical such as ethanol to kill the tumor.  Another approach is to insert a probe that emits radio waves directly into the tumor (radiofrequency ablation).

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