تومـورهای کبـد در اطفال؛ مطالعه ده ساله در مرکز طبی کودکان

Background: The aim of this study was to review the frequency, histopathology and outcome in children with tumors of the liver.Methods: Included in this retrospective/descriptive study were 30 children treated for liver tumors from 1375-1384 (ca. 1996-2005), at Children’s Hospital Medical Center, Tehran, Iran. We included the clinical, radiologic, and pathologic data of our patients, focusing on the frequency, etiology and outcome. Results: Patient ages ranged from three months to 12 years (median 3.8 years), with 18 males (60%) and 12 females (40%). Of these, 17 patients had hepatoblastoma (55.66%), including 13 males and four females, with an age range of six months to five years. Four cases (13.33%) had neuroblastoma. Hepatocellular carcinoma (HCC) was found in three cases (10%), all of whom were carriers of hepatitis B. Two cases (6.66%) were diagnosed with mesenchymal hamartoma, two cases (6.66%) with hemangioendothelioma and two cases (6.66%) with rhabdomyosarcoma and leiomyosarcoma of the biliary tract. Abdominal swelling and hepatomegaly were seen in all of patients. Jaundice was observed in two cases. Serum alpha-fetoprotein levels greater than 500 ng/ml were seen in 17 cases (56.66%). All patients were receiving specific treatment. The three-year survival rate was 65% for hepatoblastoma and 2% for HCC Conclusion: With the introduction of specific treatment, the survival rate for children with tumors of the liver has significantly increased. Further improvement can be achieved using diagnostic biopsy for hepatoblastoma, although it may result in complications, and preoperative chemotherapy followed by complete surgical excision (per International Society of Pediatric Oncology guidelines), yielding an outstanding survival rate of 80%.