Malignant liver tumors in infants and children

Abstract

Abstract At the Children’s Hospital in Washington, D.C., 18 patients have been seen in the past 12 years with primary tumors of the liver. The tumors were divided as follows: 13 hepatoblastoma, 2 hepatocellular carcinoma, 2 rhabdomyosarcoma, and 1 mixed mesenchymal sarcoma. Of the patients with hepatoblastoma, all were seen by 4 years of age, and 8 were under 1 year when first seen. Three had pulmonary metastases when first seen. The 2 patients with hepatocellular carcinoma were 8 and 12 years old, respectively. The patients with embryonal rhabdomyosarcoma were 18 and 30 months of age when seen; 1 had a primary tumor arising in the liver, the other had a tumor in the bile ducts extending into the liver. Ten of the 13 children with hepatoblastoma underwent lobectomy; 5 of these 10 are alive, 1 with known metastases. The other 4 are presumed cured. One of the children with hepatic carcinoma had severe preexisting cirrhosis of the liver and has had 3 local limited excisions. One of the patients with rhabdomyosarcoma is alive and cured after hepatic lobectomy. As yet, there is no known effective chemotherapeutic regimen. Radiation therapy has been useful only in shrinking the tumor, but neither of these modalities has resulted in cure. At the present time, the only known cures are achieved by early detection and successful surgical removal.