Scientists caution that a rare childhood liver cancer can spread to the brain
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A surprising finding by Rockefeller University scientists about a rare liver cancer’s behavior could lead to more comprehensive patient monitoring and hopefully better outcomes.

The scientists recommend that people with advanced-stage fibrolamellar hepatocellular carcinoma, which mostly affects teenagers and young adults, receive regular neuroimaging scans because of the tumor’s apparent ability to metastasize to the brain. Solid tumors, including those in the liver, don’t usually spread to the brain, so scans to monitor fibrolamellar patients’ progress typically don’t include the head.

Earlier detection of brain metastases could increase the chances of successful surgical removal of the tumors, says Sanford Simon, whose Laboratory of Cellular Biophysics previously identified the genetic driver behind fibrolamellar. It also could help clinicians to make more informed choices about what drugs to use.

Only a minority of fibrolamellar patients will develop brain metastases, Simon expects. Still, testing for that possibility is important when a tumor’s spread can have such severe consequences. About 200 cases of fibrolamellar are reported worldwide each year, though Simon believes the disease is underdiagnosed. Only about one in three patients survive beyond five years.

In a paper published recently in the journal Pediatric Blood & Cancer, he and colleagues document three

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