Hepatic benign and malignant masses in children: a single UK tertiary centre experience
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In brief
In brief
Retrospective UK tertiary centre study of 107 pediatric liver masses found 64% were benign (most commonly hemangioma), contrasting with literature stating two-thirds are malignant. Hepatoblastoma was the predominant malignancy (76%), with most lesions detected incidentally or as palpable masses requiring multimodal imaging and biopsy for diagnosis.
Written by the GCMD Library team from the article.
Abstract
Purpose
The aim of this study was to review the incidence, spectrum and investigation of liver masses presenting to our tertiary liver unit.
Methods
A retrospective single-centre cohort study of paediatric patients (age < 16 years) diagnosed with a liver mass who were investigated at a UK paediatric hepatobiliary tertiary referral centre. Data relating to the clinical findings at presentation, source of referral, diagnostic investigations and histopathology findings were recorded and analysed.
Results
107 patients were identified between July 2012 and July 2019 (55 females). 69 (64%) patients had benign liver lesions, whereas the remaining 38 (36%) were found to have malignant masses. The liver lesions were most commonly detected incidentally (33%) with the second most common presentation being with palpable mass (29%). 82 (77%) patients were referred from other hospitals. All patients underwent USS, 74% MRI, 36% CT, 5% CEUS, 1% PET and 5% HIDA scan with 47% ultimately undergoing biopsy. 72% of patients had AFP measured. The most common benign liver masses were haemangioma 33 (48%), hepatic cyst 17 (25%) and FNH 12 (19%). Amongst the malignant lesions, 29 (76%) were hepatoblastoma and 3 (8%) were hepatocellular carcinoma.
Conclusions
This large review series demonstrates that just over 1/3 of patients presenting to a paediatric tertiary referral centre with a focal liver lesion had neoplastic liver lesions, despite the published literature commonly stating that 2/3 of paediatric liver masses are malignant.