Hepatoblastoma

Hepatoblastoma (HB) is the most common primary malignant liver neoplasm in children, comprising 1% of all pediatric malignancies. Most children present with an abdominal mass and raised serum alpha-fetoprotein (AFP). Imaging of choice is triple-phase contrast-enhanced CT abdomen/MRI. The PRETEXT system is used to define the extent of liver involvement. Conventionally, hepatoblastoma is risk stratified into standard (good) risk and high risk, and current treatment is based on decades of collaborative efforts. Hepatoblastoma requires multidisciplinary management of which surgery is the mainstay. Advances in multidisciplinary care, including those in imaging, chemotherapy and surgery and increasing use of liver transplantation, have led to improved outcomes in hepatoblastoma over the past few decades from 20% to 80%. Young children need careful monitoring for the development of acute and late toxicities of treatment.