Liver Tumors

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What are liver tumors?

tumors happen when young liver cells grow out of control and form a lump (mass). Doctors do not know what causes this.

Liver are rare in children, teens and young adults. They can be noncancerous (benign) or cancerous (malignant).

The main types of liver cancer in young people are:

Hepatoblastoma
Hepatocellular carcinoma
Fibrolamellar carcinoma
Liver sarcomas

Hemangiomas ( or ) are the most common benign liver tumor in young people. Other benign liver tumors include:

Focal nodular hyperplasia
Mesenchymal hamartoma
Adenoma

Cancer and Blood Disorder Care at Seattle Children's

Our team treats babies, children, teens and young adults, including those with the hardest-to-treat cancers and blood disorders. We provide treatment options that many centers do not offer.

What are the symptoms of liver tumors?

Most children, teens and young adults with liver tumors do not have symptoms early in their disease. Some tumors are found when people get for other reasons. Usually, symptoms appear only after the tumor has grown for a while.

These symptoms may be caused by a liver tumor or by another problem. Check with a doctor about 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.
Unexplained pain in the belly.
Loss of appetite.
Nausea and vomiting.
Yellowing of the whites of the eyes or skin (jaundice).

How are liver tumors diagnosed?

Some liver tumors are found during pregnancy on prenatal . Your doctor may refer you to our Fetal Care and Treatment Center to assess your baby’s health and plan for care they will need.

To diagnose a liver tumor in a baby, child or young adult, the doctor will:

Do an exam to look for signs of the disease
Ask about your child’s health

Testing blood and tissue
These tests can help tell the type of tumor and see whether it has spread. Your doctor may:
- Test blood for certain chemicals that some liver tumors make or increase.
- Test blood to check how well the liver is working.
- Take a sample of fluid or tissue using a needle. This is called a .
- Do surgery to remove a small piece of a tumor, or other body tissue in areas that are hard to reach by needle. This is called a surgical .
Imaging studies
Your doctor may 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:
- PET scan
- Ultrasound
- CT (computed tomography) scan
- MRI (magnetic resonance imaging) scan

Risk Factors and Stages of Liver Cancer

Most children who have liver cancer do not have any risk factors. But the chance of liver cancer is higher in those who have:

Rare health problems, such as Beckwith-Wiedemann syndrome
Gardner’s syndrome or familial adenomatous polyposis
Hepatitis B or C
Liver damage caused by other health problems
Extremely premature birth

If the tumor is cancerous, it is important to find out the size and whether cancer has spread. This process is called staging.

Knowing the stage helps us plan the best treatment. Your doctor will explain the cancer’s stage.

How are liver tumors treated?

Our treatment goal is to give your child or teen the best chance of a long and healthy life. We tailor care to your child’s unique needs.

Pediatric surgeons with experience in liver surgery are key members of your team. Liver specialists () provide care as needed.

If your child has a benign, small liver tumor, they will need regular check-ups to monitor the tumor and their health. If the tumor is causing symptoms or growing, your child may need surgery to remove it.

If the tumor is cancerous, a doctor who specializes in diagnosing and treating children, teens and young adults with cancer (pediatric oncologist) will oversee your care. Surgeons, , and with expertise in liver tumors may also provide treatment. U.S. News & World Report consistently ranks our Cancer and Blood Disorders Center among the best pediatric oncology programs in the country.

For liver cancer, your healthcare team will suggest a treatment plan based on:

The cancer stage
Your child’s age
Your child’s overall health
Your family’s preferences

Seattle Children’s offers these treatment options for liver cancer:

Surgery to remove part of the liver

When they can, doctors do surgery to remove liver tumors. Usually, only part of the liver needs to be removed to get rid of the cancer (partial hepatectomy). A pediatric surgeon with expertise and subspecialty training will perform your child’s liver surgery.

If liver cancer has spread to other places in the body, doctors may remove this cancer, too. During surgery, your child will receive care from anesthesiologists who specialize in treating babies, children, teens and young adults.

Learn more about surgery to treat tumors at Seattle Children’s. We do surgery at our hospital campus in Seattle.
Liver transplant

In very rare cases of liver tumors, doctors need to remove the whole liver to get all of the cancer out of your child’s body. Then they transplant a healthy liver from a donor. Doctors will give your child other treatments for their cancer until a donor liver is available.

Seattle Children’s has the only pediatric Liver Transplant Program in our region. We will care for your child before, during and after their liver transplant. Optum’s Clinical Sciences Institute has named our liver transplant program a Center of Excellence.

We are always working to improve surgery techniques and treatments to help children who get liver transplants. To offer transplants to more people, in some cases, we do partial liver transplants from living donors.
Chemotherapy

Your child’s doctors may suggest anticancer medicine (called chemotherapy or “chemo”) either as the main treatment or along with surgery.

Before surgery, doctors may use chemotherapy to shrink the tumor to make it easier to remove. After surgery, they may use chemo to kill any cancer cells that remain in the liver or in other parts of the body.

The type of chemotherapy your child gets depends on the type of tumor. They may receive chemotherapy through a vein (called intravenous or IV). The medicine spreads around the body through the bloodstream to kill cancer cells.

Our patients receive chemotherapy at our hospital campus in Seattle. Your child may stay overnight in our Cancer and Blood Disorders Center – Inpatient or get treatment at our outpatient infusion center as a day procedure.

See more about getting chemotherapy at Seattle Children’s.
Embolization: TACE or TARE
If your child has a liver cancer that cannot be safely removed by surgery, your doctor may suggest injecting chemotherapy or tiny beads of material into the blood vessels that feed the tumor. A specialized doctor called an (IR) performs these treatments.

If chemotherapy is used, the treatment is called transarterial chemoembolization (TACE). Treatment with radioactive material (yttrium-90 or Y90) is called transarterial radioembolization (TARE).
- The IR puts special needles through your child’s skin or through a small cut in the belly or groin to reach the tumor.
- Next, the doctor injects chemotherapy or Y90 into the blood vessels that go to the tumor.
- The chemotherapy or Y90 kills cancer cells.
We give TACE treatment at our main hospital campus in Seattle. We refer patients to UW Medicine for TARE.

Research and Clinical Trials for Liver Cancers

For some children, teens and young adults with liver cancer, treatment options include taking part in research studies (clinical trials). As leaders in research groups like the Children’s Oncology Group (COG) and Pediatric Early Phase Clinical Trials Network (PEP-CTN), we can offer our patients the very latest treatments being studied.

The newest options, such as phase 1 clinical trials, may be especially important if a cancerous tumor does not respond well to standard treatment (refractory) or comes back after treatment (relapsed). Seattle Children’s offers phase 1 studies for solid tumors, including studies that reprogram the body’s infection-fighting cells to find and destroy cancer cells.

Learn about the most current cancer clinical trials at Seattle Children’s

Find many clinical trials offered at Seattle Children’s on our Current Research Studies page or on ClinicalTrials.gov. Research studies for patients with liver cancer may be listed under “hepatic malignancy” or “hepatic cancer.” Read our guide about searching for trials on ClinicalTrials.gov (PDF).
Contact us at 206-987-2106.
Email us at [email protected].
Read more about cancer research and clinical trials at Seattle Children’s.

Follow-up Care for Liver Cancers

Follow-up care is important for several 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 the tumor and treatments.

Most of our patients visit Seattle Children’s, but we also do visits by video. If you live far from Seattle, you may get some follow-up care from a cancer doctor in your own community. During follow-up visits at Seattle Children’s, your team will:

Look for any signs that cancer is returning
Check for any side effects of therapy that may happen months or years after treatment
Explain any risk for other cancers and signs to watch for

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

Why choose Seattle Children’s for liver tumor care?

To have the best result, you need care from a skilled team that is experienced in treating babies, children, teens and young adults with liver tumors. Our Solid Tumor Program team works together — and with you — for the best possible outcome.

We offer the most advanced treatments for liver tumors in our region. For both benign and cancerous liver tumors, many patients receive care from our pediatric surgeons skilled and specially trained in liver surgery. For cancerous tumors, treatment options also include anticancer medicine (), , , and .

The experts you need for complete care

Seattle Children’s serves as a referral center for the Pacific Northwest. We treat more children, teens and young adults with cancer than any other center in the region. Many of our patients return to their normal lives after treatment and never have cancer again. Year after year, our Cancer and Blood Disorders Center is ranked among the nation’s top pediatric oncology programs by U.S. News & World Report.

Your child will benefit from the work of physician-scientists at Fred Hutchinson Cancer Center and UW Medicine, as well as at Seattle Children’s. The National Cancer Institute has named our partnership a comprehensive cancer center.

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, with excellent outcomes.

Specialists in caring for babies, children, teens and young adults

Our specialty is treating our patients’ disease while helping them grow up to be healthy and productive adults.

Our team cares for your whole child. As needed, they will receive care from specialists in nutrition, pain management, child life, palliative care, pharmacy, physical therapy and emotional health. Read more about the supportive care we offer.

Children, teens and young adults do not react to illness, injury, pain and medicine in the same way as older adults. They need — and deserve — care designed just for them. We work to make surgery easier and tailor pain management for each patient. We plan treatment based on years of experience and the newest research on what works best and is safest.

We know that teens and young adults with cancer have different challenges than young children. Our Adolescent and Young Adult Cancer Program focuses on their needs, which may include fertility preservation.

Support for your whole family

Learning that your child has a liver tumor can be scary. We help your family all along the way.

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 family through the challenges. We connect you to community resources and support groups.

At Seattle Children’s, we work with 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.