Liver Tumors in Children

Abstract

Learning Objectives: After completing this course, the reader should be able to: Describe the current epidemiologic trends in hepatoblastoma.Identify the genetic syndromes that are seen in a subset of liver tumors.Assess the need for complete tumor resection in the treatment of liver tumors in children as well as the increasingly important option of liver transplantation for those patients with unresectable tumors.Discuss the impact of the hepatitis vaccine in reducing the incidence of hepatocellular carcinoma.Explain the prognostic impact of different histologic subtypes of hepatoblastoma.Promote the need for future clinical trials in testing new agents for hepatocellular carcinoma in children.Employ the different staging systems used in liver tumors, including the traditional North American postsurgical staging system and the European presurgical staging system using imaging.CME This article is available for continuing medical education credit at CME.TheOncologist.com.Malignant liver tumors account for slightly >1% of all pediatric malignancies, with roughly 150 new cases of liver tumors diagnosed in the U.S. annually. The embryonal tumor, hepatoblastoma, accounts for two thirds of malignant liver tumors in children. Other liver malignancies in children include hepatocellular carcinoma, sarcomas, germ cell tumors, and rhabdoid tumors. Benign tumors of the liver in children include vascular tumors, hamartomas, and adenomas. There is an apparent increase in the incidence of hepatoblastoma with perinatal exposures and decreased premature infant mortality as postulated causes for this increased risk. The known causes and associations of liver tumors in children as well as the approaches to diagnosis and treatment of children are discussed in this review article.