Congenital Hepatoblastoma: expanding the knowledge, improving the outcomes

Hepatoblastoma (HB) is a rare liver tumour, and its congenital counterpart (CHB) is even less frequent. CHB has a more challenging management and a generally perceived worse outcome. Aim of this study is to review available literature on CHB to better define presentation, diagnosis, available treatments, and management options. The analysis of outcomes brings attention to the different causes of death and allows to focus on new areas of intervention, like in-utero procedure to treat life threatening manifestations, together with an aggressive management of neonatal complications, and the creation of a standardized, protocol-driven, oncological approach. Overall, CHB does not seem to confer a worse oncological prognosis per se and should be managed similarly as older children, if patients are stable enough to undergo proper staging and treatment. A deeper knowledge and better outcomes would come from a large, homogeneous, collection of data possibly allowing a global protocol, focusing on a comprehensive management of CHB.