Pediatrik Hastalarda Malign Karaciğer Tümörlerinin Değerlendirilmesi: Tek Merkez Deneyimi

Amaç: Çocukluk çağında malign karaciğer tümörleri nadirdir. Hepatoblastom ve hepatoselüler karsinom en sık görülen iki tiptir. Bu çalışma ile; kliniğimizde izlenen malign karaciğer tümörü tanısı alan hastalarımızın demografik, klinik özelliklerini ve tedavi sonuçlarını geriye dönük olarak incelemeyi amaçladık. Gereç ve Yöntem: Sağlık Bilimleri Üniversitesi, Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim Araştırma Hastanesi, Çocuk Onkoloji Kliniği’nde 2010-2019 tarihleri arasında takip edilen, karaciğerde malign tümörü olan 13 olgunun demografik özellikleri, tümör lokalizasyonu, klinik ve radyolojik bulguları, histopatolojik bulguları, tedavileri ve son durumları retrospektif olarak incelendi. Bulgular: Karaciğerde malign tümörü olan 13 çocuk hasta (erkek/kız: 6/7) değerlendirildi. Hastaların ortanca yaşı 38 ay (minimum: 4- maksimum: 198 ay) olarak hesaplandı. Hepatoblastom (n=11, %84,6), hepatoselüler karsinom (n=1, %7,69), karaciğerin farklılaşmamış sarkomu (n=1, %7,69) tanıları alan hastalar mevcuttu. Hepatoblastom tanılı 1 hastada (%9) ve undiferansiye sarkom tanılı hastada alfa fetoprotein düzeyi (AFP)

Evaluation of Malignant Liver Tumors in Pediatric Patients: A Single Center Experience

Objectives: Malignant liver tumors are rare in childhood. Hepatoblastoma and hepatocellular carcinoma are the two most common types of malignant liver tumors. In our study, we reviewed the demographic, clinical features and treatment outcomes of pediatric patients with malignant liver mass followed in our clinic retrospectively. Materials and Methods: Patients with 13 malignant liver tumors, who were diagnosed in University of Health Sciences Turkey, Ankara Pediatric Hematology Oncology Training and Research Hospital, Pediatric Oncology Clinic between 2010 and 2019, were included in the study. Their files were reviewed retrospectively, and their demographic characteristics, tumor localization, clinical and radiological findings, treatments and response to treatment were also investigated. Results: Thirteen pediatric patients (male/female: 6/7) with malignant tumors in the liver were evaluated. The median age of the patients was calculated as 38 months (minimum: 4- maximum: 198 months). There were patients diagnosed with hepatoblastoma (n=11, 84.6%), hepatocellular carcinoma (n=1, 7.69%), and liver undifferentiated sarcoma (n=1, 7.69%). Alpha fetoprotein level was

PDF

___

1. Chavhan GB, Siddiqui I, Ingley KM, et al. Rare malignant liver tumors in children. Pediatr Radiol. 2019;49:1404-1421.
2. Emre S, McKenna GJ. Liver tumors in children. Pediatr Transplant. 2004;8:632-638. 3. Tanyel FC. Karaciğer tümörleri. Çoc. Cer. Derg. 2016;30:441-451.
4. Litten JB, Tomlinson GE. Liver tumors in children. Oncologist. 2008;13:812- 820.
5. Finegold MJ, Egler RA, Goss JA, et al. Liver tumors: pediatric population. Liver Transpl. 2008;14:1545-1556.
6. Sharma D, Subbarao G, Saxena R. Hepatoblastoma. Semin Diagn Pathol. 2017;34:192-200.
7. Pateva IB, Egler RA, Stearns DS. Hepatoblastoma in an 11-year-old: Case report and a review of the literature. Medicine (Baltimore). 2017;96:e5858.
8. Aronson DC, Meyers RL. Malignant tumors of the liver in children. Semin Pediatr Surg. 2016;25:265-275.
9. Meyers RL. Tumors of the liver in children. Surg Oncol. 2007;16:195-203.
10. Fernandez-Pineda I, Cabello-Laureano R. Differential diagnosis and management of liver tumors in infants. World J Hepatol. 2014;6:486-495.
11. Hughes LJ, Michels VV. Risk of hepatoblastoma in familial adenomatous polyposis. Am J Med Genet. 1992;43:1023-1025.
12. Isaacs H Jr. Fetal and neonatal hepatic tumors. J Pediatr Surg. 2007;42:1797- 1803.
13. Kelly D, Sharif K, Brown RM, et al. Hepatocellular carcinoma in children. Clin Liver Dis. 2015;19:433-447.
14. Perilongo G, Shafford EA. Liver tumours. Eur J Cancer. 1999;35:953-959.
15. Brown J, Perilongo G, Shafford E, et al. Pretreatment prognostic factors for children with hepatoblastoma-- results from the International Society of Paediatric Oncology (SIOP) study SIOPEL 1. Eur J Cancer. 2000;36:1418- 1425.
16. Czauderna P. Hepatoblastoma throughout SIOPEL trials - clinical lessons learnt. Front Biosci (Elite Ed). 2012;4:470-479.
17. Emre S, Umman V, Rodriguez-Davalos M. Current concepts in pediatric liver tumors. Pediatr Transplant. 2012;16:549-563.
18. Gao J, Fei L, Li S, et al. Undifferentiated embryonal sarcoma of the liver in a child: A case report and review of the literature. Oncol Lett. 2013;5:739- 742.
19. Lim IIP, Bondoc AJ, Geller JI, et al. Hepatoblastoma-The Evolution of Biology, Surgery, and Transplantation. Children (Basel). 2018;6:1.
20. Ranganathan S, Lopez-Terrada D, Alaggio R. Hepatoblastoma and Pediatric Hepatocellular Carcinoma: An Update. Pediatr Dev Pathol. 2020;23:79-95.
21. Divarcı E, Çelik A. Çocuklarda Solid Karaciğer Tümörleri. Turkiye Klinikleri J Pediatr Surg-Special Topics. 2015;5:10-19.
22. Khaderi S, Guiteau J, Cotton RT, et al. Role of liver transplantation in the management of hepatoblastoma in the pediatric population. World J Transplant. 2014;4:294-298.
23. Pham TA, Gallo AM, Concepcion W, et al. Effect of Liver Transplant on Long-term Disease-Free Survival in Children With Hepatoblastoma and Hepatocellular Cancer. JAMA Surg. 2015;150:1150-1158.