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Hepatoblastoma: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Hepatoblastoma is a rare tumor that affects children under 4 years of age, regardless of gender; it develops extremely rarely in older children and adults.
The first symptoms of hepatoblastoma are a rapid increase in abdominal volume, accompanied by anorexia, decreased activity of the child, fever and, in rare cases, jaundice. Manifestations of hepatoblastoma also include accelerated puberty due to the secretion of ectopic gonadotropin by the tumor, cystathionuria, hemihypertrophy and renal adenomas.
The serum alpha-fetoprotein level is significantly elevated. Visual examination methods reveal a volumetric formation in the liver, displacement from the normal position of adjacent organs, and sometimes foci of calcification. Liver angiograms show signs of primary liver cancer - diffuse plethora of the tumor, which persists in the venous phase, abundant vascularization, foci of accumulation of contrast agent and blurred contours.
The histological features of hepatoblastoma reflect the stages of embryonic liver development, so teratoid changes are sometimes observed. Usually, hepatoblastoma is a fetal-type tumor with embryonic cells in acini, pseudorosettes, or papillary structures. Sinusoids contain hematopoietic cells. In the mixed epithelial-mesenchymal type of tumor, primitive mesenchyme, osteoid, and occasionally cartilaginous tissue, rhabdomyoblasts, or epidermoid foci are found.
A link has been established between familial adenomatous polyposis of the colon and hepatoblastoma. Other combinations are also possible; a gene has been identified on chromosome 11 that is associated with hepatoblastoma and other embryonic tumors. Cytogenetic studies have revealed chromosomal abnormalities.
If liver resection is successful, the prognosis is usually better than for hepatocellular carcinoma; 36% of patients survive 5 years or more.
Cases of liver transplantation have also been described.
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