Pediatric Tumors of the Liver: A Ten-Year Study

The aim of this study was to review the frequency, histopathology, and outcome of hepatic tumors in children. In this retrospective descriptive study, medical records of 30 children treated for liver tumors from 1996 through 2005, at Childrenʹs Hospital Medical Center, Tehran, Iran were reviewed for clinical, radiologic, and pathologic data with more focus on the frequency, etiology, and outcome. The age of the patients ranged from three months to 12 years (median 3.8 years), with 18 males (60%) and 12 females (40%). Of these, 17 patients had hepatoblastoma (55.66%), including 13 males and four females, with an age range of six months to five years. Four cases (13.33%) had neuroblastoma. Hepatocellular carcinoma (HCC) was found in three cases (10%), all of whom were carriers of hepatitis B. Two cases (6.66%) were diagnosed with mesenchymal hamartoma, two cases (6.66%) with hemangioendothelioma, and two cases (6.66%) with rhabdomyosarcoma and leiomyosarcoma of the biliary tract. Abdominal swelling and hepatomegaly were seen in all patients. Jaundice was observed in two cases. Serum alpha-fetoprotein levels greater than 500 ng/mL were seen in 17 cases (56.66%). All patients received specific treatment. The three- year survival rate was 65% for hepatoblastoma and 2% for HCC. The introduction of specific treatment has significantly increased the survival rate of children with liver tumors. Further improvement can be achieved using diagnostic biopsy for hepatoblastoma, although it may result in complications, and preoperative chemotherapy followed by complete surgical excision according to the International Society of Pediatric Oncology Guidelines can yield an outstanding survival rate of 80%.