Hepatoblastomas are childhood liver tumors characterized by which of the following features?

c. Unresectable tumors subjected to cytoreductive chemotherapy may be resected with long-term survival

Children with hepatoblastoma most commonly present with an abdominal mass or diffuse abdominal swelling. The child is typically in good health and the lesion may be observed by an observant parent or clinician on routine examination. Weight loss and other symptoms are unusual. Liver function tests are usually normal or nonspecifically altered. Jaundice is uncommon. The most useful tumor marker is the serum (a-fetoprotein (AFP)) level which is elevated in approximately 90% of the cases.

Hepatoblastoma usually presents as a single, pseudo-encapsulated lesion often reaching large proportions before becoming apparent. The umbilical fissure is generally not breached. Multicentricity occurs in less than 20% and cirrhosis of the surrounding liver is unusual. Multicentricity and associated cirrhosis are typical of hepatocellular carcinoma. Complete surgical resection remains the major objective of therapy for hepatoblastoma. At presentation approximately 60% of patients with hepatoblastoma have resectable tumors. Chemotherapy is the major treatment option available for unresectable tumors. Over the last decade it has become apparent that some of these patients may be rendered resectable by preoperative chemotherapy.