Pediatric Hepatoblastoma
Introduction
Introduction to Pediatric Hepatoblastoma Pediatric hepatoblastoma is a hepatic malignancy that occurs in the liver's embryonic tissue. It occurs mostly in infants under 3 years of age. The clinical features are gradually increasing the abdomen, the upper abdomen can touch the mass, loss of appetite, weight loss, anemia and so on. In the advanced stage, there are jaundice and ascites. According to clinical manifestations and laboratory, auxiliary examination results were confirmed. Surgical resection can be cured if the tumor is solitary, the tumor is superficially small and there is no extrahepatic metastasis. basic knowledge The proportion of illness: 0.01%-0.03% Susceptible people: children Mode of infection: non-infectious Complications: ascites jaundice upper gastrointestinal bleeding
Cause
Pediatric hepatoblastoma etiology
Cause of the disease (68%):
The exact cause is unknown. Cases have been reported to be associated with fetal alcoholism or oral contraceptives in the mother. Others believe that the disease may be associated with homozygous variation of the 11p allele.
Pathogenesis (25%):
1. Pathological changes: Histologically, the tumor is immature, and the liver tissue of different degrees of differentiation can be divided into fetal type (highly differentiated type), embryo type (lowly differentiated type) and undifferentiated type (immature type). ) three subtypes.
2. Stage SIOPEL-I staging: According to the anatomical position, the liver is divided into left, right two leaves and right rear, right front, left inner and left outer four segments.
I: The tumor only affects the right posterior segment or the left segment.
IIA1: The tumor affects the right lobe of the liver.
IIA2: The tumor affects the left lobe of the liver.
IIB: The tumor involves the right posterior segment and the left segment.
IIIA1: The tumor affects the right lobe of the liver and the left inner segment.
IIIA2: The tumor affects the left lobe and right anterior segment of the liver.
IIIB1: The tumor affects the right lobe of the liver and the left outer segment.
IIIB2: The tumor affects the left lobe and right posterior segment of the liver.
IV: The tumor involves all four segments of the left and right liver.
Another: each staging can be noted: m distant metastasis e extrahepatic infiltration.
v invades the vena cava and invades the portal vein.
Prevention
Pediatric hepatoblastoma prevention
The cause is still unknown. Refer to the general tumor prevention methods, understand the risk factors of tumors, and formulate corresponding prevention and treatment strategies to reduce the risk of tumors. There are two basic clues to prevent tumors. Even if tumors have begun to form in the body, they can help. The body improves resistance, and these strategies are as follows:
1. Avoid harmful substances (promoting factors)
It is able to help us avoid or minimize exposure to harmful substances.
Some related factors of tumorigenesis are prevented before the onset, and many cancers can be prevented before they are formed. A report in the United States in 1988 compared the international malignant tumors in detail and proposed many external factors of known malignant tumors. In principle, it can be prevented, that is, about 80% of malignant tumors can be prevented by simple lifestyle changes, and traced back. In 1969, Dr. Higginson's research concluded that 90% of malignant tumors are caused by environmental factors," "Environmental factors", "lifestyle" refers to the air we breathe, the water we drink, the food we choose to make, the habits of activities, and social relationships.
2. Improve the body's immunity against tumors
Can help to strengthen and strengthen the body's immune system and cancer.
The focus of our current cancer prevention efforts should first focus on and improve those factors that are closely related to our lives, such as quitting smoking, eating properly, exercising regularly, and losing weight. Anyone who follows these simple and reasonable lifestyles can Reduce the chance of cancer.
The most important thing to improve the function of the immune system is: diet, exercise and control troubles. Healthy lifestyle choices can help us stay away from cancer. Maintaining good emotional state and proper physical exercise can keep the body's immune system at its best. Tumors and prevention of other diseases are equally beneficial. Other studies have shown that appropriate activities not only enhance the body's immune system, but also reduce the incidence of colon cancer by increasing the peristalsis of the human intestinal system. Here we mainly understand the diet in preventing tumorigenesis. Some questions.
Complication
Pediatric hepatoblastoma complications Complications ascites jaundice upper gastrointestinal bleeding
Can cause precocious puberty, secondary anemia, ascites and lower extremity edema, occasionally upper gastrointestinal bleeding and jaundice.
Symptom
Pediatric hepatoblastoma symptoms Common symptoms Abdominal pain, Abdominal mass, Ascites, Loss of appetite, Precocious puberty, Upper gastrointestinal bleeding, Weight loss
At the onset of the disease, the general symptoms are not obvious, no jaundice or fever, but the abdominal fullness is found by the parents during the bathing. Sometimes the abdominal lumps are found by the doctor during the health checkup. The slightly older children can complain of abdominal pain, and the liver cancer cells can sometimes be produced. Gonadotropin causes precocious puberty in children. Some children see pigmentation in the skin. Some children do not feel abdominal pain. The course of disease is faster than that of general malignant tumors. There may be loss of appetite, fatigue, progressive weight loss, and late stage. There may be fever, secondary anemia, ascites and lower extremity edema, occasionally upper gastrointestinal bleeding and jaundice, palpation of the liver is hard, the liver edge is hard, the surface is not smooth, there are nodules.
Examine
Pediatric hepatoblastoma examination
The detection of serum alpha-fetoprotein is extremely important for the diagnosis of liver cancer, 90% to 100% positive, higher than adult cases (70% to 80% positive for adults), many biochemicals such as protein and lipids. Quality, enzymes, etc. are all produced by the liver or metabolized in the liver. Therefore, blood cholesterol, lactate dehydrogenase (LDH), albumin, globulin, alkaline phosphatase, bilirubin and other tests can reflect liver function. Necessary, serum alkaline phosphatase is often increased, which is also helpful for the diagnosis of liver cancer.
Ultrasonography, venous urography, and radionuclide liver scan have diagnostic aids for this disease. CT and MRI (magnetic resonance imaging diagnosis) have reference value for diagnosis. Chest X-ray and photos should pay attention to the situation of lung.
Diagnosis
Diagnosis and diagnosis of hepatoblastoma in children
According to the clinical manifestations and laboratory, the results of the auxiliary examination were confirmed.
Identification with hepatitis, differentiated from neuroblastoma.
Hepatitis: It is inflammation of the liver. The causes of hepatitis may vary, the most common being caused by the virus, in addition to autoimmunity. Alcoholism can also cause hepatitis.
Neuroblastoma: It is the most common extracranial tumor in children and is the most common tumor in infants and young children. Nearly half of the neuroblastomas occur in infants and young children under 2 years of age. Neuroblastoma accounts for approximately 6-10% of childhood tumors and 15% of children with tumor mortality.
