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The association of hepatoblastoma, prematurity and cerebral palsy: Case reports
Jessica R Pruente1, Dawn E Deike2, Barbara Lockart3
1Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
Insights
Hepatoblastoma, a rare childhood liver tumor, is more common in premature infants with cerebral palsy (CP). Early recognition of symptoms like abdominal distension is crucial for timely diagnosis and treatment in these high-risk children.
Area of Science:
- Pediatric Oncology
- Neonatology
- Pediatric Neurology
Background:
- Hepatoblastoma is the most frequent primary liver tumor in pediatric patients.
- Prematurity and very low birth weight are associated with an increased incidence of hepatoblastoma.
Purpose:
Hepatoblastoma is the most common primary liver tumor in children and has a greater incidence in children with a history of prematurity and very low birth weight. To increase awareness of the association between prematurity and hepatoblastoma for health care providers who treat children with Cerebral Palsy (CP), we present two case reports.
Methods:
Two case reports of premature, very low birth weight infants with hepatoblastoma are described and a literature review of hepatoblastoma in the setting of prematurity and cerebral palsy is performed.
Results:
Each patient had a history of 26-28 week prematurity, very low birth weight, and CP. Both presented with worsening constipation and abdominal distension that did not respond to oral medications. Appropriate referrals to the ER were made which lead to a diagnosis of hepatoblastoma. Pediatric rehabilitation was a source of referral for diagnosis in one patient and aided in the rehabilitation course following treatment for both patients.
Conclusions:
Hepatoblastoma is the most common primary liver tumor in children and has an increased incidence in children with a history of prematurity and very low birth weight. Providers who frequently care for the very low birth weight and premature children with CP should be aware of this correlation and include hepatoblastoma in the differential when managing patients with suddenly worsening constipation or abdominal distension. Pediatric physiatrists and other providers for these patients could be a source of referrals and diagnosis leading to timely treatment.
