Sintusek P, Phewplung T, Sanpavat A, Poovorawan Y. Liver tumors in children with chronic liver diseases. World J Gastrointest Oncol 2021; 13(11): 1680-1695 [PMID: 34853643 DOI: 10.4251/wjgo.v13.i11.1680]
Corresponding Author of This Article
Palittiya Sintusek, MD, MSc, Associate Professor, Thai Pediatric Gastroenterology, Hepatology and Immunology Research Unit, Chulalongkorn University, 1873, Rama 4 Road, Pathumwan, Bangkok 10330, Thailand. palittiya.s@chula.ac.th
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Palittiya Sintusek, Thai Pediatric Gastroenterology, Hepatology and Immunology Research Unit, Department of Pediatrics, Division of Gastroenterology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand
Teerasak Phewplung, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Anapat Sanpavat, Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Yong Poovorawan, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok 10330, Thailand
Author contributions: Sintusek P reviewed the literature and wrote the manuscript; Phewplung T prepared, interpreted the imaging study, and provided the liver tumor images; Sanpavat A interpreted and prepared the histopathology images; Poovorawan Y edited the intellectual content in the manuscript; All authors approved the final manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Palittiya Sintusek, MD, MSc, Associate Professor, Thai Pediatric Gastroenterology, Hepatology and Immunology Research Unit, Chulalongkorn University, 1873, Rama 4 Road, Pathumwan, Bangkok 10330, Thailand. palittiya.s@chula.ac.th
Received: March 1, 2021 Peer-review started: March 1, 2021 First decision: April 19, 2021 Revised: April 27, 2021 Accepted: August 23, 2021 Article in press: August 23, 2021 Published online: November 15, 2021 Processing time: 255 Days and 19.1 Hours
Abstract
Liver tumors are rare in children, but the incidence may increase in some circumstances and particularly in chronic liver diseases. Most liver tumors consequent to chronic liver diseases are malignant hepatocellular carcinoma. Other liver tumors include hepatoblastoma, focal nodular hyperplasia, adenoma, pseudotumor, and nodular regenerative hyperplasia. Screening of suspected cases is beneficial. Imaging and surrogate markers of alpha-fetoprotein are used initially as noninvasive tools for surveillance. However, liver biopsy for histopathology evaluation might be necessary for patients with inconclusive findings. Once the malignant liver tumor is detected in children with cirrhosis, liver transplantation is currently considered the preferred option and achieves favorable outcomes. Based on the current evidence, this review focuses on liver tumors with underlying chronic liver disease, their epidemiology, pathogenesis, early recognition, and effective management.
Core Tip: Liver tumors in children are rare, although children with underlying chronic liver diseases may present a higher risk. Early detection and timely management lead to a good prognosis and outcome. Recently, contrast enhanced ultrasound has been the preferred modality for surveillance to identify and classify the etiology of liver tumors. As the more frequent liver tumors in children with chronic liver diseases are mainly malignant, liver transplant should be considered as the first option to achieve favorable results. In addition, regular assessment is necessary in asymptomatic benign liver tumors with the potential for malignant transformation.
