Abstract
The liver is the third most common site of abdominal tumors in children. This review article aims to summarize current evidence surrounding identification and diagnosis of primary hepatic tumors in the pediatric population based upon clinical presentation, epidemiology, and risk factors as well as classical imaging, histopathological, and molecular diagnostic findings. Readers will be able to recognize the features and distinguish between benign and malignant hepatic tumors within different age groups.
Highlights
The liver accounts for 5–6% of all intra-abdominal masses detected in children, with renal being the most common [1]
HB presenting later in childhood presents to other hepatic tumors, with abdominal distension or a palpable abdominal mass often associated with nonspecific symptoms such as anorexia, pain, fatigue, and weight loss [38]
There are case reports of isosexual precocity due to virilization thought to be secondary to beta human chorionic gonadotropin hormone (β-hCG) secretion by HB; these cases typically present in males under the age of 3 [40]
Summary
The liver accounts for 5–6% of all intra-abdominal masses detected in children, with renal being the most common [1]. One-third of these masses are considered to be benign, whereas two-thirds are malignant [2]. The majority of these masses present in a similar way, with progressive abdominal distension, a palpable abdominal mass, abdominal pain, and hepatomegaly. The differential for a benign hepatic mass includes infantile hepatic hemangioma, hepatic adenoma, mesenchymal hamartoma, and focal nodular hyperplasia. Hepatocellular carcinoma, malignant rhabdoid tumors, undifferentiated embryonal sarcoma, and angiosarcoma. Within the neonatal and early childhood period, hemangioma and hepatoblastoma are the most common benign and malignant primary hepatic tumors, respectively. In school-aged children and adolescents, adenomas and hepatocellular carcinoma are the most common. This review encompasses epidemiology, risk factors, clinical presentation, laboratory findings, diagnostic imaging, immunohistochemistry, and histopathologic findings of the above tumors, as organized by age and benign versus malignant classification
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