Cancers and Tumors

Liver Tumors

What are liver tumors?

Liver tumors happen when young liver cells grow out of control and form a lump (mass).

Tumors can be noncancerous (benign) or cancerous (malignant). Both kinds of liver tumors are rare in children and teens.

The 2 main types of liver cancer in children are:

  • Hepatoblastoma (HEH-puh-toh-bla-STOH-muh), which is more likely to happen in children younger than 6 years old
  • Hepatocellular carcinoma (heh-PA-toh-SEL-yoo-ler KAR-sih-NOH-muh), which is more common in children older than 6 and adults

When it is healthy, the liver does important work:

  • Helps filter harmful substances from the blood so they can leave the body as wastes
  • Makes bile, which helps digest fats
  • Stores sugar (glycogen) that the body uses for energy

  • Doctors do not know what causes liver tumors. The chance of having a liver tumor is higher in boys than in girls.

    Some things increase the chance that a child will have liver cancer. But most children who have a cancerous liver tumor do not have any risk factors.

    • Rare genetic health problems, such as Beckwith-Wiedemann syndrome, increase the chance of hepatoblastoma.
    • Hepatitis B or C or having liver damage because of other health problems increases the chance of hepatocellular carcinoma.

Liver Tumors at Seattle Children’s

At Seattle Children’s, we care for many families each year who have a child with a liver tumor. Many of the children we treat for cancer return to their normal lives after treatment and never have cancer again.

Doctors at our Cancer and Blood Disorders Center focus on curing cancer in babies, children, teens and young adults. Seattle Children’s treats more pediatric cancer than any other center in the region.

To have the best result, your child needs coordinated care by cancer doctors (oncologists), surgeons who are experts in liver surgery, pathologists and radiologists. At Seattle Children’s, our team works together – and with you – to care for your child.

Please contact the center at 206-987-2106 for more information, a second opinion or to make an appointment.

  • A doctor specially trained in diagnosing and treating cancer in children (pediatric oncologist) will guide your child’s care. At Seattle Children’s Cancer Center, our outcomes for a wide range of cancers are consistently better than the national average.

    For the past decade, U.S. News & World Report has consistently ranked Seattle Children’s Cancer Center among the best in the nation. In 2017, our program was ranked #1 in the Northwest.

    Through our partnership in the Seattle Cancer Care Alliance (SCCA), your child will benefit from the work of physician-scientists at Fred Hutch and UW Medicine, as well as at Seattle Children’s. The National Cancer Institute has designated our partnership a comprehensive cancer center.

    Our surgeons are specially trained to care for kids. In very rare cases of liver tumors, a child needs a transplant of a healthy liver from a donor. We have the only pediatric liver transplant program in the Pacific Northwest.

  • Our specialty is treating children’s disease while helping them grow up to be healthy and productive adults. Our doctors base their treatment plans on years of experience and the newest research on what works best – and most safely – for children.

    Our team cares for your whole child. We don’t just treat their disease. As needed, your child will receive care from specialists in nutrition, pain management, pharmacy, physical therapy and emotional health. Read more about the supportive care we offer.

    Children don’t react to illness, injury, pain and medicine in the same way as adults. They need – and deserve – care designed just for them. We work to make surgery easier on your child and use pain medicines made especially for children.

    Our experts focus on how treatments today affect growing bodies in the future. Dr. Eric Chow chairs the Outcomes and Survivorship Committee of the Children’s Oncology Group (COG). COG is an international organization of childhood cancer specialists who work to develop new treatments and reduce late effects of the disease and treatments.

  • Learning that your child has a liver tumor can be scary. We help take positive steps right away by offering appointments in 1 to 3 days for children suspected to have cancer.

    During visits, we take time to explain your child’s condition. We help you fully understand your treatment options and make the choices that are right for your family.

    Our doctors, nurses, child life specialists and social workers help your child and your family through the challenges of their illness. We connect you to community resources and support groups.

    At Seattle Children’s, we work with many children and families from around the Northwest and beyond. Whether you live nearby or far away, we can help with financial counseling, schooling, housing, transportation, interpreter services and spiritual care. Read about our services for patients and families.

  • We offer the most advanced treatment options for liver tumors in our region, including anticancer medicine (chemotherapy), surgery and radiofrequency ablation.

    For children whose liver must be removed because of a tumor, Seattle Children’s has the only pediatric Liver Transplant Program in the Pacific Northwest. Outcomes of patients who receive liver transplants at Seattle Children’s are among the best in the nation.

    As leaders in research groups like the Children’s Oncology Group (COG), Seattle Children’s doctors can offer our patients the very latest options being studied in clinical trials. The knowledge we gain through research improves the care we give all children with cancer.

    Read about cancer research and clinical trials at Seattle Children’s.

Symptoms of Liver Tumors

Most children, teens and young adults with liver tumors do not have symptoms early in the disease. Usually symptoms appear only after the tumor has grown there for a while.

These symptoms may be caused by a liver tumor or by another condition. Check with a doctor if your child has any of these:

  • Lump, swelling or pain in the belly (abdomen). Because the liver is tucked under the rib cage, it is not common to see or feel a lump there. But you may notice a lump if it is large. Sometimes the belly swells because fluid builds up there.
  • Weight loss for no reason.
  • Loss of appetite.
  • Nausea and vomiting.
  • Yellowing of the whites of the eyes or skin (jaundice).
  • In boys, early puberty.

Diagnosing Liver Tumors

To find out whether your child has a liver tumor, your child’s doctor will start by:

  • Checking your child for signs of the disease
  • Asking about your child’s health

These tests can help tell the type of tumor and see whether it has spread. Your doctor may:

  • Test blood for levels of certain chemicals that liver tumors make or increase.
  • Take a sample of fluid or tissue using a needle, called needle biopsy or fine-needle aspiration.
  • Do surgery to remove a small piece of a tumor, lymph node or other body tissue in areas that are hard to reach by needle. This is called a biopsy.
  • Take pictures of the inside of your child’s body (imaging studies) to look for tumors or areas where cancer is active.

Imaging studies may include:

  • X-ray
  • Ultrasound
  • CT (computed tomography) scan
  • MRI (magnetic resonance imaging) scan

Stages of Liver Cancer

If your child’s tumor is cancerous, it is important to find out the size and whether cancer has spread. This process is called staging. Knowing the stage of your child’s cancer helps your doctor plan the right treatment.

Children who have liver tumors are considered to be at 1 of these stages:

Stage 1: Doctors removed all the cancer through surgery.

Stage 2: Doctors removed all the cancer that could be seen without a microscope. Some cancer cells remain, or some may have gone into the belly during surgery.

Stage 3: Any 1 of these is true:

  • Doctors cannot remove the tumor through surgery.
  • After surgery, there is still cancer large enough to see without a microscope.
  • The cancer has spread to lymph nodes near the tumor.

Stage 4: The cancer has spread to other parts of the body.

Treating Liver Tumors

Our goal of treatment is to give your child or teen the best chance of a long and healthy life. Your child’s doctor and health care team will suggest a treatment plan for your child based on:

  • The stage of their cancer
  • Your child’s age
  • Their overall health
  • Your family’s preferences

Seattle Children’s offers these treatment options:

  • When they can, doctors remove liver tumors using surgery. Usually, only part of the liver needs to be removed to get rid of the cancer (partial hepatectomy).

    If your child’s liver cancer has spread to other places in the body, doctors may use surgery to remove this cancer, too.

    Surgery is done at our hospital’s main campus in Seattle.

    Learn more about surgery to treat tumors at Seattle Children’s.

  • In very rare cases of liver tumors, doctors need to remove the entire liver. Then they transplant a healthy liver from a donor into your child.

    As the only pediatric liver transplant program in the Pacific Northwest, we provide care before, during and after liver transplant. Doctors will give your child other treatments for their cancer until a donor liver is available.

    Outcomes of patients who receive liver transplants at Seattle Children’s are among the best in the nation. In 2016, Optum’s Clinical Sciences Institute once again named our liver transplant program a Center of Excellence.

    We are continually improving surgery techniques and treatments to help children who get liver transplants. To offer transplants to more children who need one, we have perfected techniques using split-liver transplants and partial organs from living donors.

    Learn more about Seattle Children’s Liver Transplant Program.

  • Your child’s doctors may suggest medicine called chemotherapy:

    • As your child’s main treatment
    • Before surgery to shrink tumor size
    • After surgery to kill any cancer cells that remain

    Children with liver cancer get these medicines through a vein (called intravenous or IV). The medicine spreads around the body through the bloodstream to kill cancer cells. The type of chemotherapy your child gets depends on the type of tumor.

    Our patients receive chemotherapy at our hospital’s main campus in Seattle. Your child may stay overnight in our Cancer Care Unit or get treatment at our infusion center as a day procedure.

    See more about getting chemotherapy at Seattle Children’s.

  • If your child has hepatoblastoma that comes back after treatment (recurs), your doctor may suggest using heat to treat it. This treatment is called radiofrequency ablation.

    • The doctor puts special needles through your child’s skin or through a small cut (incision) in the belly to reach the tumor.
    • Next, the doctor uses high-energy radio waves to heat the needles and the tumor.
    • The heat kills cancer cells.

    We give this treatment at our hospital’s main campus in Seattle.

  • Many children, adolescents and young adults choose to take part in research studies while receiving their standard medical treatment. These studies are called clinical or therapeutic trials.

    Our leadership in COG and other research groups means Seattle Children’s patients have access to the latest options being studied, including phase 1 clinical trials. These early studies are especially important for patients whose cancer does not respond to treatment or comes back after treatment.

    Research helps us:

    • Better understand how liver cancer starts and grows
    • Learn whether new treatments or techniques work better than current treatments
    • Reduce long-term effects of cancer and its treatment

    Learn more about cancer clinical trials at Seattle Children’s

Follow-up care

Follow-up care is important for 5 years after cancer treatment ends – no matter what type of treatment your child had. Checkups happen more often during the first 18 months. The schedule will depend on your child’s tumor and their treatments.

Most of our patients visit Seattle Children’s. If you live far from Seattle, your child may get some follow-up care from a cancer doctor in your own community.

Our Cancer Survivor Program helps young people stay healthy after being treated for cancer in childhood.

During follow-up visits at Seattle Children’s, your child’s team will:

  • Look for any signs that cancer is returning
  • Check for effects that may happen months or years after treatment
  • Tell you and your child about any risk for other cancers and signs to watch for

Contact Us

Contact the Cancer and Blood Disorders Center at 206-987-2106 for an appointment, a second opinion or more information.

To make an appointment, you can call us directly or get a referral from your child’s primary care provider. We encourage you to coordinate with your pediatrician or family doctor when coming to Seattle Children’s.

Providers, see how to refer a patient.