Purpose or Case Report: Hepatocellular carcinoma is the second most common pediatric liver tumor. Metabolic disorders, hepatitis B or C infection, and certain genetic mutations have been implicated in the development of HCC, and adolescents are the most commonly affected age group. The prevalence of this disease has decreased with increased hepatitis B immunization efforts, but approximately 50-70% of all pediatric hepatocellular carcinoma develops in the absence of underlying liver disease or genetic predisposition. Five-year survival outcome ranges between 13% and 28% with the best outcomes seen in the setting of complete surgical resection. Therefore, imaging plays an important role in diagnosis as well as in guiding management of these patients. Through this educational exhibit, we will discuss the imaging findings of hepatocellular carcinoma, initial imaging evaluation and staging, the role of imaging in ongoing management, and briefly review locoregional treatment options which can play a role in palliation, bridge to liver transplant, or potentially in downstaging disease.
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