Hepatoblastoma

  • Etiology: tumor of embryonic origin
  • Imaging: need to characterize the lesion and assess for surgical resectability – tumor can be focal or multifocal, local / region spread to lymph nodes and adjacent structures, distant spread to lungs, vascular invasion
  • CT: has coarse / chunky calcification, enhances irregularly and less than the liver
  • Complications: metastases to lung (17%) / lymph nodes, vascular obliteration / encasement / invasion / tumor thrombus, peritoneal nodules, rupture, multifocality
  • Clinical: elevated AFP (90%), premature infants are at increased risk, 70% in first 2 years / 90% by 5 years / 4% congenital, associated with Beckwith-Wiedemann syndrome / Gardener syndrome / familial adenomatous polyposis / Trisomy 18 / Type 1A glycogen storage disease

Radiology Cases of Hepatoblastoma

CT and US and angiogram of hepatoblastoma
Axial CT without (above left) and with (above right) contrast of the abdomen shows a large, coarsely calcified, heterogenously enhancing liver mass. US image (below left) shows its multinodular nature and an angiogram (below right) shows its neovascularity.