Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2014; 6(7): 486-495
Published online Jul 27, 2014. doi: 10.4254/wjh.v6.i7.486
Differential diagnosis and management of liver tumors in infants
Israel Fernandez-Pineda, Rosa Cabello-Laureano
Israel Fernandez-Pineda, Rosa Cabello-Laureano, Department of Pediatric Surgery, Virgen del Rocio Children’s Hospital, Sevilla 41013, Spain
Author contributions: Fernandez-Pineda I and Cabello-Laureano R designed the review article and wrote the manuscript.
Correspondence to: Israel Fernandez-Pineda, MD, Department of Pediatric Surgery, Virgen del Rocio Children’s Hospital, Av. Manuel Siurot s/n, t. 0034 955012924, Sevilla 41013, Spain.
Telephone: +34-955-012924 Fax: +34-955-012805
Received: January 21, 2014
Revised: March 21, 2014
Accepted: May 31, 2014
Published online: July 27, 2014

During the first year of life, most of the liver neoplasms are benign in origin, but some of these histologically benign lesions may be challenging in their management. Although most hepatic hemangiomas can be safely observed until involution is documented, some patients will need treatment due to progressive hepatomegaly, hypothyroidism and/or cardiac failure. Large mesenchymal hamartomas may require extensive hepatic resection and an appropriate surgical plan is critical to obtain good results. For malignant neoplasms such as hepatoblastoma, complete surgical resection is the mainstay of curative therapy. The decision about whether to perform an upfront or delayed resection of a primary liver malignant tumor is based on many considerations, including the ease of resection, surgical expertise, tumor histology and stage, and the likely chemosensitivity of the tumor. This article reviews the initial management of the more common hepatic tumors of infancy, focusing on the differential diagnosis and treatment options.

Keywords: Hepatoblastoma, Hepatic hemangioma, Mesenchymal hamartoma, Undifferentiated embryonal sarcoma of the liver, Focal nodular hyperplasia

Core tip: Management of liver neoplasms during the first year of life may be challenging. Some of these tumors may be observed but others require extensive surgical resection and adjuvant therapies. Differential diagnosis and treatment options are discussed in our article.