Childhood hepatocellular carcinoma (childhood HCC) is a rare type of malignant (cancerous) tumor that forms in the cells and tissues of the liver. Childhood HCC is usually found in older children and adolescents (10-14 years), but has been found in children younger than 5. Symptoms may include a mass in the abdomen, a swollen and painful abdomen, weight loss, poor appetite, yellowing of the skin and eyes (jaundice), vomiting, fever, itchy skin, and a decreased number of red blood cells (anemia). The cause of childhood HCC is not well understood; however, underlying disorders that cause liver dysfunction (ex. hepatitis B) and congenital or genetic disorders that affect the liver (ex. tyrosinemia type 1) may increase the risk for childhood HCC to occur. Treatment options vary depending on a variety of factors including the stage of the cancer and may include surgery to remove the tumor and chemotherapy.

The symptoms of childhood hepatocellular carcinoma (childhood HCC) are similar to the symptoms found in other liver cancers, commonly presenting with an abdominal mass and pain. Other common symptoms include abdominal swelling and discomfort, weight loss, anorexia, fever, vomiting, and yellowing of the skin and eyes (jaundice).

Children living in regions of the world where the hepatitis B virus is common have been reported to have a much greater risk of developing this disease. Chronic infection by hepatitis C virus has also been linked to the development of childhood HCC. Childhood HCC has also been reported to develop in the presence of liver disease, cirrhosis, and genetic disorders such as tyrosinemia type 1, glycogen storage disease type 1, and glycogen storage disease type IV.In addition, various other reported risk factors for developing childhood HCC include: male sex, family history of this carcinoma, and exposure to aflatoxin by food contamination.

Treatment options for a tumor that can be removed by surgery at the time of diagnosis may include:

• Surgery alone to remove the tumor
• Surgery and chemotherapy
• Combination chemotherapy followed by surgery to remove the tumor

Treatment options for a tumor that cannot be removed by surgery at the time of diagnosis may include:

• Chemotherapy to shrink the tumor followed by surgery
• Chemotherapy to shrink the tumor and if surgery to remove the tumor is not possible: liver transplant or chemoembolization of the hepatic artery to shrink the tumor
• Radioembolization of the hepatic artery to relieve symptoms and improve quality of life

Treatment for a childhood HCC that has spread to other parts of the body may include a combination of chemotherapy and surgery to remove as much of the tumor from the liver as possible as well as other places where the cancer has spread. If the childhood HCC is related to a hepatitis B viral infection, treatment may additionally include antiviral medications.