Pediatric liver tumors: initial presentation, image finding and outcome.
BACKGROUND
Few reports have been carried out on the characteristics of pediatric liver tumors.


METHODS
A retrospective study of 57 patients diagnosed with liver tumors from 1989 through 2004 was conducted. They were classified into groups; 10 benign, 33 primary malignant and 14 metastatic liver tumors. Their demographics, initial presentations, laboratory data, image findings and outcomes were investigated and compared.


RESULTS
Hepatocellular carcinoma (HCC) with 91% hepatitis B virus-related, constituted 23 of 33 primary malignant liver tumors and had the poorest survival rate. Initially, 70% of patients with primary malignant liver tumors were at disseminated stages. All of HCC and 88% of hepatoblastoma had elevated serum levels of aphal-fetoprotein. However, abnormal liver function tests as alanine aminotransferase, total bilirubin, albumin and alkaline phosphatase were uncommon in patients with pediatric liver tumors. Metastatic liver tumors compared with primary malignant liver tumors showed hypo-echogenicity in abdominal ultrasound (US) exam and a lesser presence of vessel invasion and contrast enhancement in computed tomography studies (P < 0.01).


CONCLUSIONS
It is important to diagnose primary malignant liver tumors before their clinical symptoms and signs develop. Children with chronic hepatitis B virus infection must be followed every 6 months by serum aphal-fetoprotein and abdominal US even when their liver function tests are normal. Image studies with abdominal US and computed tomography scan can differentiate between primary and metastatic liver tumors.
Wang
Jiaan-Der
JD
Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan. jiaander@vghtc.gov.tw
Chang
Te-Kau
TK
Chen
Hou-Chuan
HC
Jan
Sheng-Ling
SL
Huang
Fang-Liang
FL
Chi
Ching-Shiang
CS
Lin
Chieh-Chung
CC
D000293:Adolescent; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D003952:Diagnostic Imaging; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D008297:Male; D012189:Retrospective Studies