Pediatric Primary Hepatic Tumors: Diagnostic Considerations

Lucas, Bryony; Ravishankar, Sanjita; Pateva, Irina

doi:10.3390/diagnostics11020333

Cited by 31 publications

(54 citation statements)

References 170 publications

(339 reference statements)

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“…1,[19][20][21] As preoperative chemotherapy is increasingly becoming the standard of care, core needle biopsy and fine-needle aspiration are often utilized in the first instance, to provide tissue for paraffin preparation and immunohistochemistry. 5,13 Fine needle aspiration (FNA) is rarely utilized in the diagnostic approach to liver lesions. However, it may be used alongside radiology when a benign lesion is suspected.…”

Section: Diagnostic Considerationsmentioning

confidence: 99%

“…5 The main distinguishing feature between these two tumors is the unique stromal component assigned to HB, however a significant diagnostic challenge is posed by the overtly HCC-like macrotrabecular variant. 5,12,13 The major subtypes appear as follows:…”

Section: Microscopic Featuresmentioning

confidence: 99%

“…Congenital HB may be detected as early as the start of the third trimester by maternal ultrasound, presenting as a single, solid, echogenic lesion. 9 , 13 In children, CT and MRI scan aid in distinguishing HB from other tumors of childhood, such as mesenchymal hamartoma and pediatric hepatocellular carcinoma (HCC), though in this context MRI is preferred due to its superior discernment of mixed soft tissues. 1 , 5 , 16 MRI may reveal an epithelial tumor component, vascular invasion and the presence of fibrotic bands.…”

Section: Radiologic Assessmentmentioning

confidence: 99%

“…In such circumstances, imaging should be taken in the clinical context of serum AFP levels, which fall post-treatment and tend to rise with recurrence and repetitive CT surveillance. 3 , 13 , 18 …”

Section: Radiologic Assessmentmentioning

confidence: 99%

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Surgical Pathology Diagnostic Pitfalls of Hepatoblastoma

Auld

Sergi

2022

Int J Surg Pathol

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Hepatoblastoma (HB) is the most common malignancy within the rare cohort of pediatric primary liver tumors. It may arise sporadically or in association with germline mutations in specific genetic syndromes. Histogenesis recapitulates fetal hepatic development, however, this tumor can exhibit a markedly heterogeneous appearance both macroscopically and under the microscope. Histologic subtypes are classified based on morphologic appearance, with additional discrimination based on emerging molecular and immunohistochemical features. Numerous diagnostic pitfalls exist from clinical presentation through to ancillary testing; at all stages, the surgical pathologist must be discerning and open to collaboration with colleagues of different specialties. Problematic areas include the adequacy of tissue sampling, correlation of histology with radiologic appearance and alpha feto-protein (AFP) serology, forming a diagnostic consensus within the pediatric pathology community and choosing a shrewd immunohistochemical panel. This review discusses the sequence of events leading up to histologic assessment, and the nuances of microscopic evaluation. Along the way, pitfalls are highlighted, providing a tool for the surgical pathologists to support their individual approach.

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Section: Diagnostic Considerationsmentioning

confidence: 99%

Section: Microscopic Featuresmentioning

confidence: 99%

Section: Radiologic Assessmentmentioning

confidence: 99%

Section: Radiologic Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Pathology Diagnostic Pitfalls of Hepatoblastoma

Auld

Sergi

2022

Int J Surg Pathol

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“…Furthermore, the incidence of childhood malignancies is increasing worldwide, with less than 40% of children receiving an appropriate diagnosis and treatment ( Oyefiade et al, 2021 ; Sze, 2021 ). The symptoms of childhood malignancies are often similar to those of other common, benign diseases, so early and accurate diagnosis is difficult, with an untimely diagnosis an important cause of delayed treatment and mortality ( Van Paemel et al, 2020 ; Jain et al, 2021 ; Lucas et al, 2021 ). Although significant progress has been made in the treatment of childhood malignancies in recent years, tumor treatment based on surgery and radiotherapy can only kill tumor cells, not effectively control the recurrence and metastasis of some childhood tumors ( Weiser et al, 2019 ; Casey and Cheung, 2020 ; Cimini et al, 2020 ; Fair et al, 2020 ; Greenbaum et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Emerging Role and Mechanism of circRNAs in Pediatric Malignant Solid Tumors

Shen

Liu

et al. 2022

Front. Genet.

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Circular RNAs (circRNAs) are non-coding RNAs with covalent closed-loop structures and are widely distributed in eukaryotes, conserved and stable as well as tissue-specific. Malignant solid tumors pose a serious health risk to children and are one of the leading causes of pediatric mortality. Studies have shown that circRNAs play an important regulatory role in the development of childhood malignant solid tumors, hence are potential biomarkers and therapeutic targets for tumors. This paper reviews the biological characteristics and functions of circRNAs as well as the research progress related to childhood malignant solid tumors.

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Beckwith–Wiedemann syndrome with multiple hepatic and cutaneous hemangiomas in a female patient of Albanian origin: Diagnostic and therapeutic considerations

Moutafi,

Gkiourtzis,

Ververi

et al. 2023

American J of Med Genetics Pt A

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We describe a 2‐month‐old female infant with macroglossia, macrosomia, omphalocele, neonatal hypoglycemia, earlobe creases, low nasal bridge, midface retrusion, syndromic facies and multiple cutaneous and hepatic hemangiomas (HH). Genetic evaluation confirmed the diagnosis of Beckwith–Wiedemann Syndrome (BWS) with mosaic uniparental disomy 11 as the underlying genetic mechanism suggested by partial hypermethylation of H19/IGF2:IG‐DMR and partial hypomethylation of KCNQ1OT1:TSS‐DMR on chromosome 11p15.5. Pediatric endocrinology and cardiology assessments were normal. No malignant liver or renal tumors were detected during the follow‐up period. Treatment with propranolol was started for the multiple HH, according to international recommendations. At 3‐, 6‐, and 9‐month follow up, a gradual decrease in the size of the hemangiomas and AFP levels was observed, without side effects. This is the fifth case in the literature combining HH and BWS, and among these, the third case with this specific genetic defect suggesting a possible association between HH and BWS caused by 11 paternal uniparental disomy [upd(11)pat]. The case also highlights that if treatment is warranted, then oral propranolol can be used for the management of infantile HH in BWS patients similarly to non‐BWS patients.

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Pediatric Primary Hepatic Tumors: Diagnostic Considerations

Cited by 31 publications

References 170 publications

Surgical Pathology Diagnostic Pitfalls of Hepatoblastoma

Surgical Pathology Diagnostic Pitfalls of Hepatoblastoma

Emerging Role and Mechanism of circRNAs in Pediatric Malignant Solid Tumors

Beckwith–Wiedemann syndrome with multiple hepatic and cutaneous hemangiomas in a female patient of Albanian origin: Diagnostic and therapeutic considerations

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