Diagnosis and treatment of pediatric hepatoblastoma (Atena Editora)

Abstract

INTRODUCTION: Hepatoblastoma is the most common primary liver tumor in children. Most cases appear in the first two years of life, and rarely appear after the age of five. The incidence of hepatoblastoma in children has increased over the years and, therefore, it is important to know in more detail its treatment and diagnostic methods. METHODOLOGY: A careful literature review was carried out in which 8 articles were selected in Portuguese, English and Spanish, published between 2016-2020 using the descriptors hepatoblastoma; pediatric; treatment; through the Scielo, Google Scholar and Pubmed databases. DISCUSSION: Hepatoblastoma typically presents in children under three years of age, with an abdominal mass, anemia, and vomiting. The diagnosis of the disease is made through clinical characteristics, serum alpha-fetoprotein (AFP) levels, characteristic findings on ultrasound imaging (USG) and the child's age. Typically, a mass is found in the right lobe of the liver and, in more than 90% of cases, it is associated with high AFP dosage. USG with Doppler shows hypervascularization in the region. In addition, a Magnetic Resonance Imaging or a Computed Tomography is performed to detect possible metastases and to better characterize the tumor. In many cases, however, a biopsy is necessary to confirm the diagnosis and to guide the therapy to be carried out. The main differential diagnoses are congenital cysts, abscesses and other neoplasms, such as hemangioma. Treatment is mainly carried out through complete surgical resection. To carry it out, the PRETEXT classification is used, which divides patients into 4 groups according to the extent and location of the tumor. Furthermore, chemotherapy can be performed in patients who are not suitable for resection, radiofrequency removal in patients with metastases, and liver transplantation. CONCLUSION: This summary confirms the importance of early diagnosis and specific treatment for children with hepatoblastoma, as this is a highly relevant disease, especially in children under three years of age. Therefore, further studies are necessary in order to better classify and treat patients affected by the disease.