Liver Tumors

What are liver tumors?

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

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

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
  • Hepatocellular carcinoma (heh-PA-toh-SEL-yoo-ler KAR-sih-NOH-muh), which is more common in children older than 6 and in adults

Liver Tumors at Seattle Children’s

At Seattle Children's, we care for many children each year who have a liver tumor. We treat more pediatric cancer than any other center in the region. Many of the children we treat return to their normal lives after treatment and never have cancer again.

If you would like an appointment, ask your primary care provider to refer you to our Cancer and Blood Disorders Center.

If you have a referral or would like a second opinion, contact the center at 206-987-2106.

Providers, see how to refer a patient.

  • The experts you need for complete care

    To have the best result, your child needs multidisciplinary care by doctors skilled in treating children with liver tumors. Our Solid Tumor Program team works together – and with you – to get the best outcome for your child.

    A doctor who specializes in diagnosing and treating children with cancer (pediatric oncologist) will oversee your child’s care. Pediatric surgeons with experience in liver surgery are also key members of your child’s team, along with pathologists, radiologists, radiation oncologists and gastroenterologists.

    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.

    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, with excellent outcomes. Optum’s Clinical Sciences Institute has named our liver transplant program a Center of Excellence.

  • Specialists in caring for children and teens

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

    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, palliative care, pharmacy, physical therapy and emotional health.  Read more about the supportive care we offer.

    Children do not 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. We plan your child’s treatment based on years of experience and the newest research on what works best — and most safely — for children.

    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 take positive steps right away by offering appointments in 1 to 3 days for children suspected to have cancer. If needs are not urgent, new patients can be seen in 1 to 2 weeks.

    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.

  • The most advanced therapies and clinical trials

    We offer the most advanced treatment options for liver tumors in our region. Options include anticancer medicine (chemotherapy), surgery, immunotherapy, radiation therapy and radiofrequency ablation.  

    As leaders in research groups like the Children’s Oncology Group (COG), 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 your child has a cancerous tumor that does not respond well to treatment (refractory) or that comes back after treatment (relapsed).

    At Seattle Children’s, our current research studies include reprogramming the body’s infection-fighting T cells to find and destroy cancer cells. This phase 1 clinical trial, called STRIvE-01, may be an option for children and young adults with refractory or relapsed liver cancer. We have one of the nation’s largest pipelines of CAR T-cell immunotherapy trials for children and young adults

    Read more 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 for a while.

These symptoms may be caused by a liver tumor or by another problem. 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:

  • Examining your child for signs of the disease
  • Asking about your child's health
  • Risk factors for liver cancer

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

    • Rare genetic health problems, such as Beckwith-Wiedemann syndrome
    • Hepatitis B or C
    • Liver damage caused by other health problems
  • 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 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.
  • 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:

    • 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.

Your child’s doctor will explain the stage of your child’s cancer. The stage helps us plan how best to treat your child’s cancer. 

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:

  • 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).

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

    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. Then they transplant a healthy liver from a donor into your child. 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 children who need one, we have perfected techniques using split-liver transplants and partial organs from living donors.

  • Chemotherapy

    Your child's doctors may suggest anticancer medicine called chemotherapy:

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

    The type of chemotherapy your child gets depends on the type of tumor. They may receive chemotherapy:

    • Delivered directly into the tumor, called transarterial chemoembolization.
    • 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.

  • Radiofrequency ablation

    If your child has a hepatoblastoma that comes back (recurs) after treatment, 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 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 campus in Seattle.

  • Clinical trials for liver tumors

    For some children, teens and young adults with cancerous liver tumors, the treatment options include taking part in research studies (clinical trials).

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. 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

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

Contact Us 

If you would like an appointment, ask your child’s primary care provider for a referral.

If you have a referral or would like a second opinion, call the Cancer and Blood Disorders Center at 206-987-2106.

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Paying for Care

Learn about paying for care at Seattle Children’s, including insurance coverage, billing and financial assistance.

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