Feb 4, 2013

Hepatoblastoma

Introduction:
The liver is a large, very important organ situated in the right upper quadrant of abdomen. The normal functions of the liver in the body are: 


To help store nutrients from food
To break down and remove harmful chemicals from the body
To build chemicals that the body needs to stay healthy.


Hepatoblastoma: The most common type of liver cancer in children is Hepatoblastoma. it occurs most frequently in infants or very young children between 2 months and 2 year.

Symptoms:
  • Lump in the abdomen (most common)
  • Reduced appetite
  • lethargy
  • nausea / vomiting
  • Pain in abdomen
  • Jaundice
Investigations:The following minimal investigations are proposed to diagnose hepatoblastoma

  • Tumor markers- serum AFP
  • CT scan of abdomen with Ct guided FNAC or Biopsy
  • X-ray ches/CT Chest
  • Complete blood count
  • Biochem profile
Treatment: 

Surgery & chemotherapy are two treatment options

Surgery: Liver resection according to the location & extent of the tumor. It will be either
  • Rt hepatectomy
  • Lt hepatectomy
  • Extended Rt or Lt hepatectomy
  • Bi or trisegmentectomy
If liver resection is not possible because of multicentric disease then liver transplant is the only treatment of option.

Chemotherapy:
Chemotherapy is given before or after surgery. Surgery is done either as a sandwich surgery (in between cycles of chemotherapy) or it is done at the start & then chemotherapy is given.


The drugs used in chemotherapy are
  • Cisplatin
  • Doxorubicin
  • Vincristine
  • 5-Fluorouracil