Hepatoblastoma and hepatocellular carcinoma are the most common malignant tumor of liver. These represent about 2% of all malignancies in childhood and 15% of malignant abdominal masses. Hepatoblastoma (HB) is the most common primary malignant neoplasm of the liver in children mostly seen in males less than four year of age. Diagnostic work-up (US, Scintigraphy, CT-Scan) objective is predicting resectability and tumor extension. Diagnostic laparotomy will decide resectability. Markers associated to this tumor are: alpha-fetoprotein and gamma-glutamyltransferase II. Only reliable chances of cure is surgical excision although half are unresectable at dx. Unresectable tumors can be managed with preop chemotx. Disadvantages of preop chemotx are: progressive disease, increase morbidity, post-op complications, and toxicity. Advantages are: decrease in tumor size, covert three-fourth cases into resectable, although extent of surgery is not decreased. Tumor necrosis is more extensive in pt. receiving preop chemotx. Osteoid present in tumors after chemotx may represent an inherent ability of the tumor to maturate and differentiate. Diploid tumors on DNA flow cytometry show a better prognosis.
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