How do you approach treatment of metastatic hepatocellular carcinoma in an adolescent?

Clarification - do you mean fibrolamellar carcinoma? Often mistakenly treated or referred to as a HCC variant or as a subset of HCC? Does it have the characteristic DNAj-PRKACA fusion for FLC? Is there underlying liver disease?

Or do you mean conventional HCC? (common in older adults with liver dise...