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Malignant Liver Tumors
Paula J. Woodward, MD
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KEY FACTS

  • Imaging

    • Clinical Issues

      TERMINOLOGY

      • Definitions

        • 3 most common malignant fetal liver tumors
          • Hepatoblastoma
            • Malignant embryonic hepatic tumor composed of epithelial cells and occasionally mixture of epithelial and mesenchymal cells
            • Most common primary malignancy
          • Metastases
            • Typically neuroblastoma
            • All other metastases exceedingly rare
          • Leukemic infiltration
            • Most commonly transient abnormal myelopoiesis associated with trisomy 21

      IMAGING

      • General Features

        • Imaging Recommendations

          DIFFERENTIAL DIAGNOSIS

            PATHOLOGY

            • General Features

              • Microscopic Features

                CLINICAL ISSUES

                • Presentation

                  • Demographics

                    • Natural History & Prognosis

                      • Treatment

                        DIAGNOSTIC CHECKLIST

                        • Image Interpretation Pearls

                          Selected References

                          1. Koh V et al: Neuroblastoma in children under 12 months in singapore--15-year experience and outcomes from KKH. Fetal Pediatr Pathol. 34(3):155-61, 2015
                          2. Miura Y et al: Diagnosis and treatment of a preterm infant with inoperable congenital hepatoblastoma--a case report. J Pediatr Hematol Oncol. 37(3):e188-90, 2015
                          3. Nagaraj UD et al: Diagnostic imaging of fetal and neonatal abdominal and soft tissue tumors. Curr Pediatr Rev. 11(3):143-50, 2015
                          4. Cheng YK et al: A fetus with a huge neck mass and a large abdominal circumference--a rare case of sialoblastoma and hepatoblastoma. Prenat Diagn. 32(9):915-7, 2012
                          5. Fisher JP et al: Neonatal neuroblastoma. Semin Fetal Neonatal Med. 17(4):207-15, 2012
                          6. Fouché C et al: [Fetal hepatosplenomegaly in the third trimester: A sign of leukemia in fetuses with Down syndrome.] J Gynecol Obstet Biol Reprod (Paris). 39(8):667-71, 2010
                          7. Makin E et al: Fetal and neonatal liver tumours. Early Hum Dev. 86(10):637-42, 2010
                          8. Miric Tesanic D et al: Metastatic fetal neuroblastoma with non immune fetal hydrops. Ultraschall Med. 31(5):520-2, 2010
                          9. Desai G et al: Prenatal detection of an extra-adrenal neuroblastoma with hepatic metastases. J Ultrasound Med. 28(8):1085-90, 2009
                          10. Hadi E et al: Telomere aggregates in trisomy 21 amniocytes. Cancer Genet Cytogenet. 195(1):23-6, 2009
                          11. Chou ST et al: Trisomy 21 enhances human fetal erythro-megakaryocytic development. Blood. 112(12):4503-6, 2008
                          12. Allen AT et al: Mirror syndrome resulting from metastatic congenital neuroblastoma. Int J Gynecol Pathol. 26(3):310-2, 2007
                          13. Isaacs H Jr: Fetal and neonatal hepatic tumors. J Pediatr Surg. 42(11):1797-803, 2007
                          14. Holmes DK et al: Hematopoietic progenitor cell deficiency in fetuses and children affected by Down's syndrome. Exp Hematol. 34(12):1611-5, 2006
                          15. Izraeli S: Perspective: chromosomal aneuploidy in leukemia--lessons from down syndrome. Hematol Oncol. 24(1):3-6, 2006
                          16. Jamieson DH: Focal hepatic lesions in neonates. Pediatr Radiol. 36(5):468, 2006
                          17. Aviram R et al: Prenatal imaging of fetal hepatoblastoma. J Matern Fetal Neonatal Med. 17(2):157-9, 2005
                          18. Woodward PJ et al: From the archives of the AFIP: a comprehensive review of fetal tumors with pathologic correlation. Radiographics. 25(1):215-42, 2005
                          19. Bayoumy M et al: Prenatal presentation supports the in utero development of congenital leukemia: a case report. J Pediatr Hematol Oncol. 25(2):148-52, 2003
                          20. Isaacs H Jr: Fetal and neonatal leukemia. J Pediatr Hematol Oncol. 25(5):348-61, 2003
                          21. Izraeli S: Congenital syndromes and leukemia: clues to pathogenesis. Rev Clin Exp Hematol. 7(3):246-60, 2003
                          22. Robertson M et al: Prenatal diagnosis of congenital leukemia in a fetus at 25 weeks' gestation with Down syndrome: case report and review of the literature. Ultrasound Obstet Gynecol. 21(5):486-9, 2003
                          23. Shih JC et al: Congenital hepatoblastoma. Ultrasound Obstet Gynecol. 16(1):103, 2000
                          24. Doss BJ et al: Placental involvement in congenital hepatoblastoma. Pediatr Dev Pathol. 1(6):538-42, 1998
                          25. Macones GA et al: Fetal hepatosplenomegaly associated with transient myeloproliferative disorder in trisomy 21. Fetal Diagn Ther. 10(2):131-3, 1995
                          Related Anatomy
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                          Related Differential Diagnoses
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                          References
                          Tables

                          Tables

                          KEY FACTS

                          • Imaging

                            • Clinical Issues

                              TERMINOLOGY

                              • Definitions

                                • 3 most common malignant fetal liver tumors
                                  • Hepatoblastoma
                                    • Malignant embryonic hepatic tumor composed of epithelial cells and occasionally mixture of epithelial and mesenchymal cells
                                    • Most common primary malignancy
                                  • Metastases
                                    • Typically neuroblastoma
                                    • All other metastases exceedingly rare
                                  • Leukemic infiltration
                                    • Most commonly transient abnormal myelopoiesis associated with trisomy 21

                              IMAGING

                              • General Features

                                • Imaging Recommendations

                                  DIFFERENTIAL DIAGNOSIS

                                    PATHOLOGY

                                    • General Features

                                      • Microscopic Features

                                        CLINICAL ISSUES

                                        • Presentation

                                          • Demographics

                                            • Natural History & Prognosis

                                              • Treatment

                                                DIAGNOSTIC CHECKLIST

                                                • Image Interpretation Pearls

                                                  Selected References

                                                  1. Koh V et al: Neuroblastoma in children under 12 months in singapore--15-year experience and outcomes from KKH. Fetal Pediatr Pathol. 34(3):155-61, 2015
                                                  2. Miura Y et al: Diagnosis and treatment of a preterm infant with inoperable congenital hepatoblastoma--a case report. J Pediatr Hematol Oncol. 37(3):e188-90, 2015
                                                  3. Nagaraj UD et al: Diagnostic imaging of fetal and neonatal abdominal and soft tissue tumors. Curr Pediatr Rev. 11(3):143-50, 2015
                                                  4. Cheng YK et al: A fetus with a huge neck mass and a large abdominal circumference--a rare case of sialoblastoma and hepatoblastoma. Prenat Diagn. 32(9):915-7, 2012
                                                  5. Fisher JP et al: Neonatal neuroblastoma. Semin Fetal Neonatal Med. 17(4):207-15, 2012
                                                  6. Fouché C et al: [Fetal hepatosplenomegaly in the third trimester: A sign of leukemia in fetuses with Down syndrome.] J Gynecol Obstet Biol Reprod (Paris). 39(8):667-71, 2010
                                                  7. Makin E et al: Fetal and neonatal liver tumours. Early Hum Dev. 86(10):637-42, 2010
                                                  8. Miric Tesanic D et al: Metastatic fetal neuroblastoma with non immune fetal hydrops. Ultraschall Med. 31(5):520-2, 2010
                                                  9. Desai G et al: Prenatal detection of an extra-adrenal neuroblastoma with hepatic metastases. J Ultrasound Med. 28(8):1085-90, 2009
                                                  10. Hadi E et al: Telomere aggregates in trisomy 21 amniocytes. Cancer Genet Cytogenet. 195(1):23-6, 2009
                                                  11. Chou ST et al: Trisomy 21 enhances human fetal erythro-megakaryocytic development. Blood. 112(12):4503-6, 2008
                                                  12. Allen AT et al: Mirror syndrome resulting from metastatic congenital neuroblastoma. Int J Gynecol Pathol. 26(3):310-2, 2007
                                                  13. Isaacs H Jr: Fetal and neonatal hepatic tumors. J Pediatr Surg. 42(11):1797-803, 2007
                                                  14. Holmes DK et al: Hematopoietic progenitor cell deficiency in fetuses and children affected by Down's syndrome. Exp Hematol. 34(12):1611-5, 2006
                                                  15. Izraeli S: Perspective: chromosomal aneuploidy in leukemia--lessons from down syndrome. Hematol Oncol. 24(1):3-6, 2006
                                                  16. Jamieson DH: Focal hepatic lesions in neonates. Pediatr Radiol. 36(5):468, 2006
                                                  17. Aviram R et al: Prenatal imaging of fetal hepatoblastoma. J Matern Fetal Neonatal Med. 17(2):157-9, 2005
                                                  18. Woodward PJ et al: From the archives of the AFIP: a comprehensive review of fetal tumors with pathologic correlation. Radiographics. 25(1):215-42, 2005
                                                  19. Bayoumy M et al: Prenatal presentation supports the in utero development of congenital leukemia: a case report. J Pediatr Hematol Oncol. 25(2):148-52, 2003
                                                  20. Isaacs H Jr: Fetal and neonatal leukemia. J Pediatr Hematol Oncol. 25(5):348-61, 2003
                                                  21. Izraeli S: Congenital syndromes and leukemia: clues to pathogenesis. Rev Clin Exp Hematol. 7(3):246-60, 2003
                                                  22. Robertson M et al: Prenatal diagnosis of congenital leukemia in a fetus at 25 weeks' gestation with Down syndrome: case report and review of the literature. Ultrasound Obstet Gynecol. 21(5):486-9, 2003
                                                  23. Shih JC et al: Congenital hepatoblastoma. Ultrasound Obstet Gynecol. 16(1):103, 2000
                                                  24. Doss BJ et al: Placental involvement in congenital hepatoblastoma. Pediatr Dev Pathol. 1(6):538-42, 1998
                                                  25. Macones GA et al: Fetal hepatosplenomegaly associated with transient myeloproliferative disorder in trisomy 21. Fetal Diagn Ther. 10(2):131-3, 1995