Benign Liver Tumors
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Benign liver tumors in children are heterogenous in their imaging, physiologic and histologic characteristics. However, they are rarely life threatening and if treatment is needed it is rarely surgical. Both medical and surgical therapy are largely driven by the presence of symptoms and asymptomatic lesions are best left alone except in the case of a hepatic adenoma presenting without classic predisposing risk factors.
Although children may be at increased risk for size related complications from large liver tumors due to their smaller body habitus, the natural history and treatment indications for benign liver tumors in children are almost identical to that of adults. Liver transplantation may be considered for large, symptomatic lesions that are deemed unresectable but is rarely necessary as first line therapy. Children with benign liver tumors generally do well with complications attributable to the specific presenting symptoms, acuity and extent of surgical resection if needed.
Although rare in children, pediatric surgeons need to be aware of the key tenets in the diagnosis and management of benign liver tumors. As most of these lesions are asymptomatic, the key features of management include establishing the diagnosis, determining a plan for surveillance and educating the patient and family.