AIM: To examine the differences of clinical behaviors between hepatocellular carcinomas (HCC) and hepatoblastomas (HB) in children. METHODS: From 1979 to 1997, we collected 73 HCC and 54 HB from two major medica...AIM: To examine the differences of clinical behaviors between hepatocellular carcinomas (HCC) and hepatoblastomas (HB) in children. METHODS: From 1979 to 1997, we collected 73 HCC and 54 HB from two major medical centers in Taiwan. Demographic, laboratory and radiological data, and survival curves were statistically compared. RESULTS: HCC clinically differed from HB in mean age (10.6 vs2.5 years; P〈0.001), status of hepatitis B infection (56/56 vs4/35, P〈0.001) and accompanying liver cirrhosis (26/40 vs 0/30, P〈0.001), portal vein thrombi (22156 vs 5/38, P=0.006) and para-aortic lymphadenopathy (10/56 vs 1/38, P=0.026). Due to a higher recurrence rate (7/12 vs 2/13, P=0.041), stage I HCC compared poorly in survivals with stage I HB (P=0.0183). Chemotherapy could only benefit HB as evidenced by 66.7% of resectability conversion and improve survivals for advanced HB, even with unsuccessful conversion. The survival difference between stage I HB and advanced HB with delayed complete resection was of borderline insignificance (P=0.0507). CONCLUSION: I-ICC and HB were preliminarily distinguishable by some dinical dues. Delayed resection after chemotherapy was only possible for HB. However, further studies are needed to strengthen our observation that appropriate reliance upon chemotherapy to subsequently resect advanced HB could achieve the comparable survival to that of stage I HB.展开更多
OBJECTIVE Mesenchymal hamartoma of the liver (MHL) is a rare disease that makes up about 5%-8% of primitive hepatic tumors in children. The etiology of MHL has been the subject of considerable discussion. The possibil...OBJECTIVE Mesenchymal hamartoma of the liver (MHL) is a rare disease that makes up about 5%-8% of primitive hepatic tumors in children. The etiology of MHL has been the subject of considerable discussion. The possibility of malignant transformation of MHL is inclusive. To enhance the recognition of MHL in children, we have review the procedures in diagnosis and treatment and present 4 of our own cases. METHODS The clinical characteristics of MHL in 4 children including history, physical examination, lab examination, imaging data and pathology were analyzed and discussed and related to reports from the literature. RESULTS All the cases were diagnosed with B-ultrasonography and CT preoperatively, and were confirmed intra-operatively and histologically. Satisfactory results were reached postoperatively. CONCLUSION MHL is an uncommon benign lesion in children. The main presentation is abdominal painless mass. Diagnosis is aided with B-ultrasonography and CT preoperatively. Complete tumor removal is the best choice for MHL treatment resulting in a good outcome.展开更多
文摘AIM: To examine the differences of clinical behaviors between hepatocellular carcinomas (HCC) and hepatoblastomas (HB) in children. METHODS: From 1979 to 1997, we collected 73 HCC and 54 HB from two major medical centers in Taiwan. Demographic, laboratory and radiological data, and survival curves were statistically compared. RESULTS: HCC clinically differed from HB in mean age (10.6 vs2.5 years; P〈0.001), status of hepatitis B infection (56/56 vs4/35, P〈0.001) and accompanying liver cirrhosis (26/40 vs 0/30, P〈0.001), portal vein thrombi (22156 vs 5/38, P=0.006) and para-aortic lymphadenopathy (10/56 vs 1/38, P=0.026). Due to a higher recurrence rate (7/12 vs 2/13, P=0.041), stage I HCC compared poorly in survivals with stage I HB (P=0.0183). Chemotherapy could only benefit HB as evidenced by 66.7% of resectability conversion and improve survivals for advanced HB, even with unsuccessful conversion. The survival difference between stage I HB and advanced HB with delayed complete resection was of borderline insignificance (P=0.0507). CONCLUSION: I-ICC and HB were preliminarily distinguishable by some dinical dues. Delayed resection after chemotherapy was only possible for HB. However, further studies are needed to strengthen our observation that appropriate reliance upon chemotherapy to subsequently resect advanced HB could achieve the comparable survival to that of stage I HB.
文摘OBJECTIVE Mesenchymal hamartoma of the liver (MHL) is a rare disease that makes up about 5%-8% of primitive hepatic tumors in children. The etiology of MHL has been the subject of considerable discussion. The possibility of malignant transformation of MHL is inclusive. To enhance the recognition of MHL in children, we have review the procedures in diagnosis and treatment and present 4 of our own cases. METHODS The clinical characteristics of MHL in 4 children including history, physical examination, lab examination, imaging data and pathology were analyzed and discussed and related to reports from the literature. RESULTS All the cases were diagnosed with B-ultrasonography and CT preoperatively, and were confirmed intra-operatively and histologically. Satisfactory results were reached postoperatively. CONCLUSION MHL is an uncommon benign lesion in children. The main presentation is abdominal painless mass. Diagnosis is aided with B-ultrasonography and CT preoperatively. Complete tumor removal is the best choice for MHL treatment resulting in a good outcome.