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Mechanistic Association of Hepatoblastoma with Cerebral Palsy: A Narrative Review
Noor Saeed Hasan1, Warren Thomas1
1School of Medicine, Royal College of Surgeons in Ireland, Medical University of Bahrain, Kingdom of Bahrain.
Insights
Children with cerebral palsy (CP) face increased risks for hepatoblastoma, a rare childhood liver cancer. Factors like immune dysfunction and reduced physical activity in CP patients contribute to this elevated cancer risk.
Area of Science:
- Pediatric Oncology
- Neurodevelopmental Disorders
- Immunology
Background:
- Hepatoblastoma is a rare pediatric liver cancer often associated with low birth weight.
- Cerebral palsy (CP) is a neurodevelopmental disorder affecting motor skills, frequently linked to complications like severe constipation.
- Sudden worsening constipation in children with CP may indicate underlying hepatoblastoma.
Purpose of the Study:
- To review and summarize the current understanding of hepatoblastoma risks in children with cerebral palsy.
- To identify factors contributing to increased cancer susceptibility in CP patients.
Main Methods:
- Literature review summarizing existing research on hepatoblastoma and cerebral palsy.
- Analysis of potential risk factors including immune system function, metabolic disruption, and physical activity levels.
Main Results:
- Children with CP may have weakened immune surveillance due to elevated inflammatory markers (e.g., C-reactive protein, tumor necrosis factor-alpha).
- Metabolic disruptions, poor nutrition, and reduced physical activity in CP patients can impair immune function, increasing cancer risk.
- Limited physical activity in CP children negatively impacts immune cell populations (T-cells, NK cells, neutrophils).
Conclusions:
- Multiple factors associated with cerebral palsy contribute to an increased risk of developing childhood cancers, particularly hepatoblastoma.
- Clinicians should consider hepatoblastoma in CP patients presenting with acute worsening constipation.
- Further research into immune system modulation and nutritional support in CP may mitigate cancer risks.
Abstract:
Hepatoblastoma is a rare liver cancer that occurs most often in children who present with lower birth weight. Cerebral palsy (CP) is a neurodevelopmental disorder distinguished by irregularities in muscle tone, movement, and motor skills. CP is caused by damage to the developing brain and is often associated with secondary complications such as severe constipation. Clinicians must be aware of sudden worsening constipation occurring in CP children because it can also be a sign of hepatoblastoma. The aim of this review is to summarize the current understanding of the risks for hepatoblastoma development in children with CP. Cancer risks likely include dysfunction of the immune system surveillance in CP children. Elevated C-reactive protein and tumor necrosis factor-alpha levels may be higher in children with CP, which weakens their innate immune system. Metabolic disruption increases the risk of some cancers, and poor nutrition and reduced growth that occur in CP patients may have an impact on cancer development through a loss in immune function. Increased mobility and physical activity can increase the T-cell, natural killer cell, and neutrophil population. Children with CP tend to engage poorly in physical activity, and consequently, their immune system is affected. There are multiple factors associated with CP that increase the risk of childhood cancers such as hepatoblastoma.
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