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Benign and Malignant Pediatric Liver Masses: Radiologic-Pathologic Update from the Pediatric LI-RADS Working Group.

Mitchell A Rees1, Michael R Acord1, Lara E Berklite1

  • 1From the Department of Radiology, Nationwide Children's Hospital, 700 Children's Dr, ED Bldg 4th Fl, Columbus, OH 43205 (M.A.R., E.M.C.); Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (M.R.A.); Departments of Pathology (L.E.B.) and Radiology (C.E.M., G.R.S., A.J.T.), Cincinnati Children's Hospital, Cincinnati, Ohio; Department of Radiology and Imaging Sciences, Emory University and Children's Healthcare of Atlanta, Atlanta, Ga (A.L.A., G.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (A.B.K.); Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill (E.R.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (E.R.); Department of Radiology, Stanford University, Stanford, Calif (A.B.S.); Department of Radiology, Section of Pediatric Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colo (E.R.T.); and Department of Radiology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pa (J.H.S.).

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|October 23, 2025
PubMed
Summary

This review summarizes common pediatric liver tumors, distinguishing between benign and malignant types. Understanding age-related presentation and imaging is key for accurate diagnosis of these rare childhood cancers.

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Area of Science:

  • Pediatric oncology
  • Hepatology
  • Diagnostic imaging

Background:

  • Primary pediatric liver tumors are uncommon but can be life-threatening.
  • Malignant liver tumors constitute 1%-2% of pediatric malignancies.
  • Diagnosis is challenging due to low incidence and variable outcomes.

Purpose of the Study:

  • To review common benign and malignant pediatric liver lesions.
  • To highlight differences in presentation and treatment compared to adults.
  • To update current understanding of pediatric liver tumors.

Main Methods:

  • Review of common pediatric liver lesions, both benign and malignant.
  • Discussion of age-specific diagnostic clues.
  • Analysis of imaging characteristics, including MRI and contrast-enhanced US.

Main Results:

  • Some lesions like hemangioma and hepatoblastoma are exclusive to children.
  • Adult tumors like hepatocellular carcinoma can occur in children but present differently.
  • Imaging modalities like MRI and US offer diagnostic insights but have limitations.

Conclusions:

  • Patient age is crucial for differential diagnosis of pediatric liver tumors.
  • Integrating imaging findings with underlying pathology enhances diagnostic confidence.
  • Accurate diagnosis requires awareness of specific tumor behaviors and imaging nuances.