Liver tumors in children

Abstract

Introduction: Liver tumors occupy a special position in oncology pathology in children due to their origin. Difficulties in this area are a subject to a number of factors such as delayed visit to the doctor, the occult clinical symptoms in this pathology, changing clinical manifestations, a wide range of pathologies that are manifested though similar clinical picture. Primary liver tumors in children have an incidence of 3% of cases and ranks 3rd place among abdominal tumors, after Wilms tumor and neuriblastoma. Liver tumors affect most commonly children of 0-5 years. Aim: To demonstrate the data of personal observations in children with this pathology. Material and methods: The National Center of Pediatric Surgery “Natalia Gheorghiu” 2004 trough 2011 received 21 children with tumors of liver. Distribution of children by age: up to a year (n=4), from 1 to 3 years of age (n=9), 4-7 years of age (n=4) and 4 children from 8 to 18 years of age. Separation for sex was 10 girls and 11 boys. All children went through ultrasound study, for 11 children - scintigraphy of the liver, 14 - computed tomography and for one - nuclear magnetic resonance. After preparatory treatments they were made 15 biopsies, 1 - lobectomy, 1 - subtotal extirpation of tumor and 4 total extirpation of the tumor. Results: The final diagnoses were as follows in 20 (23%) children - mass in retroperitoneal space, in 17 (19,5%) - the mass in the abdominal cavity: in 3 (3%) - intestinal, in 10 (11,5%) - liver, in 20 (23%) - the internal female genital organs, 3 (3%) - the spleen, 2 (2%) - the stomach and one echinococcus of the mesentery. Conclusions: One of the key topics in medicosurgery treatment of liver tumors in children is reanimatological treatment, intensive care syndrome at preoperative stage. All surgical interventions in children with liver tumor are at high anesthesiology risk as a result of endo-toxicities, high intraoperative trauma, high potential of hemodynamic changes, of homeostasis, metabolic, respiratory and liver deregulations etc. In most cases total exterpation of malignant liver tumors is limited especially in bilateral tumors and of their central localization.