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A Clinicopathological Study of Paediatric Liver Tumours in a Tertiary Care Hospital
Esakki Muthuvel1, Vimal Chander2, Chitra Srinivasan3
1Associate Professor, Department of Pathology, Saveetha Medical College, Chennai, Tamil Nadu, India.
Insights
Hepatoblastoma is the most common paediatric liver tumour, followed by epithelioid haemangioendothelioma. This study analyzed 39 paediatric liver tumours, detailing their incidence, clinical behavior, and histopathology for improved treatment strategies.
Area of Science:
- Pediatric Oncology
- Hepatobiliary Malignancies
- Tumor Pathology
Background:
- Paediatric primary liver tumours represent a significant portion of childhood neoplasms, with hepatoblastoma being the most prevalent.
- These tumours are rare, accounting for approximately 0.5% to 2% of all paediatric neoplasms.
Purpose of the Study:
- To determine the incidence of paediatric liver tumours over a five-year period.
- To investigate the clinical behavior, alpha-fetoprotein (AFP) correlation, and histopathological characteristics of these tumours.
Main Methods:
- Retrospective analysis of patient data from tumour board and medical records over five years.
- Review of gross features and histopathological slides for diagnosis confirmation.
- Clinicopathological correlation was performed.
Main Results:
- A total of 39 paediatric liver tumours were identified; 32 (82%) were malignant and 7 (18%) were benign.
- Hepatoblastoma was the most common (71.8%), predominantly of the pure epithelial type (89.4%).
- Epithelioid haemangioendothelioma was the second most common (15.4%), with increased serum AFP in some cases.
Conclusions:
- The spectrum of paediatric liver tumours differs from adult liver tumours.
- Hepatoblastoma and epithelioid haemangioendothelioma are the most frequent paediatric liver tumours.
- Improved pathological diagnosis, staging, imaging, and multimodal therapies are crucial for enhancing survival rates in children with these tumours.
Introduction:
Paediatric primary liver tumours are the third largest group of solid abdominal neoplasms in children next to neuroblastoma and Wilms tumour, accounting for about 0.5% to 2% of all paediatric neoplasms, in which hepatoblastoma is the most common.
Aim:
The present study was done to estimate the incidence of paediatric liver tumours over a period of five years and also, to study the clinical behaviour, alpha-fetoprotein correlation and histopathological features of paediatric liver tumours.
Materials And Methods:
The details of patients treated for paediatric liver tumours for a period of five years were retrospectively retrieved from the tumour board and medical records. The gross features and all the slides were reviewed and the pathologic diagnosis was confirmed and clinicopathological correlation was then done.
Results:
A total of 39 paediatric liver tumours were detected during five years, of which 32 (82%) were malignant and seven (18%) were benign with a male to female ratio of 1:1.1. Hepatoblastoma was the most common liver tumour accounting for 28 cases (71.8%), of which 25 cases (89.4%) were of pure epithelial type. The second most common primary tumour was epithelioid haemangioendothelioma with six cases (15.4%) with female preponderance, followed by two cases each of hepatocellular carcinoma and undifferentiated embryonal sarcoma and one case of hepatocellular adenoma. Serum AFP level was increased in hepatoblastoma and in hepatocellular carcinoma, normal in hepatocellular adenoma and embryonal sarcoma. Serum AFP level was increased in few cases of epithelioid haemangioendothelioma.
Conclusion:
The spectrum of liver tumours in children is different from that in the adults. Hepatoblastoma is the most common paediatric liver tumour, followed by epithelioid haemangioendothelioma. Through better understanding of pathological diagnosis, refined surgical staging, newer and more effective radiological techniques and standardized multimodal therapies, a substantial number of children diagnosed with this highly malignant tumour can expect to survive the disease.
