Liver Tumors Flashcards
What are the most common liver tumors in children <3 years of age?
Hepatoblastomas
What tumor marker should be checked in all children with liver tumors?
AFP
What is the most common benign liver tumor?
Hemangioendothelioma
What is the natural course of hemangioendotheliomas?
These lesions eventually regress spontaneously.
Under what conditions would hemangioendotheliomas require treatment?
If the lesion is symptomatic and unresectable, or if there is an associated consumption coagulopathy, treatment may be pursued.
What is the most common primary malignant liver tumor?
Hepatoblastoma
Which children are at higher risk for development of hepatoblastoma?
Premature infants and Beckwith-Wiedemann syndrome.
What tumor marker is elevated in patients with hepatoblastoma?
AFP
What is the typical treatment for hepatoblastoma?
Resection is recommended upfront if possible. Chemotherapy, additional surgery, and transplant depend on risk group.
What are the chemotherapeutic agents most commonly used in the treatment of hepatoblastoma?
Cisplatin, fluorouracil, and vincristine.
When would liver transplant be indicated in a child with hepatoblastoma?
Transplant is necessary if a complete resection is not possible after multiple rounds of chemotherapy.
What infections increase the risk for development of hepatocellular carcinoma?
Hepatitis B and C
Which liver tumor is the 2nd most common primary liver malignancy and most common in children >3 years of age?
Hepatocellular carcinoma
What liver tumor is most likely in a child <6 months old who presents with multiple liver lesions and a normal AFP?
Hemangioendothelioma
What liver tumor is most likely in a 2 year old ex-premature infant with a liver mass and significantly elevated AFP?
Hepatoblastoma
What liver tumor is most likely in an 8 year old with a solitary liver mass and an elevated AFP?
Hepatocellular carcinoma
What liver tumor is most likely in an adolescent female on oral contraceptives presenting with a hepatic mass?
Adenoma
How does an adenoma classically present in adolescent females?
Adolescent females on OCPs will present with a solitary hepatic mass.
Name four benign liver tumors.
Hemangioendothelioma, mesenchymal hamartoma, focal nodular hyperplasia, and liver cell adenoma.
What is the most likely diagnosis in children <2 years old with a hepatic mass and a normal AFP?
Hemangioendothelioma
What is the most likely etiology of metastatic disease to the liver in children <2 years of age?
Neuroblastoma
What are the (3) most likely etiologies of metastatic disease to the liver in older children?
Lymphoma, sarcoma, or Wilms tumor.
