HEPATOCELLULAR CARCINOMA IN CHILDHOOD

Hepatocellular carcinoma in childhood is histologically identical to hepatoma seen in the adult and is associated 50% of the time to a prior liver disorder (i.e. tyrosinemia, hepatitis type B, etc.). Associated anomalies and conditions are: hemihypertrophy, osteoporosis, lipid storage disease, glycogen storage disease, virilization in males. Clinical presentation is asymptomatic abdominal mass, with abdominal pain and weight loss in 25% of patients. Diagnostic work-up includes: alpha-fetoprotein, chest x-ray, abdominal films, IVP, ultrasound, liverspleen scan, CAT scan, and occasionally arteriogram. Hepatic resection has provided the only cures. In patients with initially unresectable tumor or in postresection patients, chemotherapy is employed. Among those patients in whom the entire tumor can be resected, survival is 80% at two years. Unresectable tumors have a dismal prognosis. ADR (adriamycin) is the principal chemotherapeutic agent.