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Malignant Liver Tumors in Children and Adolescents: 12 Years Experience of a Referral Center for Pediatric Cancer in Brazil
Liver tumors are rare in children and adolescents, representing 0.3 to 2% of all pediatric tumors, with an annual rate of 0.5 to 2.5 per million inhabitants in western countries, and their prognosis depends basically on the histological type, tumor size and resectability.
Report a series of cases of childhood and adolescence malignant liver tumors treated at a referral center for pediatric cancer in Brazil, describing the clinical findings, diagnosis, treatment and clinical evolution of cases.
Retrospective, descriptive and cross-sectional study of 21 patients treated at a referral center for pediatric cancer from 2005 to 2017.
Of the total number of patients (n = 21), hepatoblastoma (n=8) and hepatocellular carcinoma (n=3) were the most commom diagnosis, and the most common clinical signs were abdominal tumor (95.2%), abdominal pain (38%), and fever (19%). Abdominal ultrasound was the first complementary exam performed in 95.2% of patients and alpha-fetoprotein (AFP) was elevated in eleven cases, all cases of hepatoblastoma and hepatocellular carcinoma. Of the total of cases, nineteen patients (90.5%) were treated by chemotherapy combined to surgical resection. Five-year survival rates for all patients with malignant liver tumors were 32%.
Childhood and adolescence malignant liver tumors are rare, abdominal mass is the most common clinical manifestation, and abdominal ultrasound was the main complementary exam at initial investigation. Hepatoblastoma was the most common malignant histology followed by hepatocelullar carcinoma, and regarding its treatment, chemotherapy± radiotherapy combined to surgical resection was the most commom modality of treatment for primary tumors or liver metastases.
malignant, liver, pediatric, adolescent
LUIS CESAR BREDT, FERNANDA EZURE BREDT, CARMEN LUIS FIORI