TY - CHAP M1 - Book, Section TI - Liver Tumors A1 - Meyers, Rebecka L. A1 - Tiao, Greg M. A2 - Ziegler, Moritz M. A2 - Azizkhan, Richard G. A2 - Allmen, Daniel von A2 - Weber, Thomas R. Y1 - 2014 N1 - T2 - Operative Pediatric Surgery, 2e AB - Liver tumors are rare in children accounting for about 1.5% of all childhood malignancies. Primary pediatric malignant tumors include hepatoblastoma (HB), hepatocellular carcinoma (HCC), rhabdoid tumors, and sarcomas.Age at presentation and level of alpha fetoprotein (AFP) are often the keys to differential diagnosis.HB accounts for about 80% of the malignant tumors in children and the incidence appears to be increasing.Pre-treatment extent of disease (PRETEXT) is based on cross-sectional imaging assessment of the extent of tumor involvement of the 4 main sections of the liver.Surgical resection is recommended (1) by lobectomy or segmentectomy at diagnosis for PRETEXT I and II, (2) by lobectomy or trisegmentectomy after neoadjuvant chemotherapy for PRETEXT III (or POSTTEXT I, II or III and no major venous involvement −V and −P), and (3) by liver transplant or extreme resection for POSTTEXT III+V+P, and for any PRETEXT IV.Only 0.5 to 1% of all Hepatocellular Carcinoma (HCC) manifest before 20 years of age and more than two-thirds of those are older than 10 years of age.Chemotherapy is ineffective for HCC so primary radical tumor resection should be considered and all available techniques should be used to achieve this goal. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1100439511 ER -