Liver resection in children with hepatic neoplasms

Area of Science:

• Hepatobiliary Surgery
• Pediatric Oncology
• Surgical Pathology

Background:

• Primary liver tumors in children are rare but require timely diagnosis and management.
• A spectrum of benign and malignant neoplasms can affect the liver in pediatric populations.
• Treatment strategies vary significantly based on tumor type, size, and location.

Purpose of the Study:

• To review the management and outcomes of primary liver tumors treated over a ten-year period.
• To evaluate the efficacy of surgical and non-surgical interventions for both benign and malignant liver neoplasms in children.
• To identify factors contributing to successful treatment and cure.

Main Methods:

• Retrospective analysis of 28 patients with primary liver tumors treated over ten years.
• Categorization of tumors into benign (hamartomas, focal nodular hyperplasia, cysts, hemangiomas) and malignant (hepatoblastomas, hepatocellular carcinomas, embryonal rhabdomyosarcoma) types.
• Review of surgical interventions, including excision and marsupialization, and non-surgical treatments like steroids and radiation therapy.

Main Results:

• Eleven benign tumors were identified, with recommendations for excision of hamartomas and focal nodular hyperplasia, marsupialization for large cysts, and resection for hemangiomas.
• Of 17 malignant tumors, 12 were hepatoblastomas, with four cures (33%) achieved through liver resection.
• One cure each was achieved for hepatocellular carcinoma and embryonal rhabdomyosarcoma via surgical excision.

Conclusions:

• Surgical resection is the primary curative treatment for malignant primary liver tumors in children.
• Management of benign liver tumors should prioritize resection when feasible, avoiding life-threatening procedures.
• Conservative management or adjuvant therapies may be considered for unresectable or complex cases.