Pediatric liver tumors

Like adults, secondary liver tumors in children are more common than primary liver tumors. Primary liver malignancies account for 1.2% to 5% of pediatric tumors, the most common of which are hepatoblastoma and hepatocellular carcinoma. Benign tumors are mainly hemangioma, hamartoma, and teratoma. Hepatoblastoma is more common than hepatocellular carcinoma, and almost all occur in children before the age of 5 years. About 50% of patients are younger than 18 months. Boys are more common than girls, especially hepatocellular carcinoma, male to female is 2: 1. The peak age of developing hepatocellular carcinoma is 10 to 14 years. Similar to nephroblastoma, congenital malformations such as hemi-limb hypertrophy and extensive hemangiomas can be complicated by hepatic malignancies. Liver tumors and nephroblastomas can occur in the same patient. Hepatoblastoma and hepatocellular carcinoma have been reported in twins. Almost all hepatoblastomas occur in the normal liver, and pediatric hepatocellular carcinoma is often accompanied by cirrhosis or original liver parenchymal lesions. Liver malignancies such as cirrhosis secondary to biliary atresia and giant cell hepatitis have increased. In addition, liver tumors have been reported in patients treated with androgen for congenital aplastic anemia (Fanconis anemia). If children with chronic hereditary chrominopathy survive to about 2 years of age, the risk of developing hepatocellular carcinoma can reach 40%.

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