Primary Hepatic Tumor in Children

孩童原發性肝腫瘤

黃炫鈆(Hsuan-Chiene Huang) ； 李鍾祥(Chung-Hsiang Lee) ； 李廷堅(Ting-Chien Lee)

《Acta Paediatrica Sinica》 15卷3期 (1974/09) Pp. 98-106

摘要

自1965年至1973年，共有47例被孩童診斷爲原發性肝腫瘤，於臺大醫院小兒科住院。其中27例有病理組織診斷，20例爲臨床診斷。27例經病理組織證實之病例中，24例爲惡性腫瘤，3例良性腫瘤。惡性腫瘤羣之年齡分佈自45至15歲，而良性腫瘤皆發生於兩歲以前，男女之比約爲二比一。臨床上之主要症狀爲腹部痛或不適，腹部腫瘤及腹脹。次要症狀爲食慾不振，全身不適及體重減輕。47例全部有肝腫其中7例有脾腫檢驗方面除了甲型胎蛋白較爲敏感之外，無其它較爲敏感之檢驗法以供診斷。治療方面唯一的方法是早期開刀切除，如此對良性瘤有很大的效果，但對惡性瘤仍是無濟於事。
本文就以上47例之病情經提出報告，並參考文獻加以討論之。

並列摘要

This is a review of 47 children clinically diagnosed as primary hepatic tumor at National Taiwan University Hospital during the past nine years (1965-1973). The diagnosis of 27 cases were histologicaly proved 20 cases were not. (Fig. 1) Among the 27 documented cases, 24 were of malignant tumors (22 cases of liver cell carcinoma, 2 cases of mixed tumor of the liver) and three cases were of benign tumors (1 case of hemangioma, 2 case of infantile hemangioendothelioma). The ages of the children inflicted with malignant tumors ranged from 45 days to 15 years, while all cases of the benign tumors occurred during their fist two years of life. Males seemed more susceptible to primary hepatic tumor than females; the sex ratio of male to female was about 2 to 1. (Table 1) The major symptoms of primary hepatic tumor were abdominal discomfort or pain, palpable abdominal mass, and abdominal distention. Minor symptoms were anorexia, general malaise, and loss of weight. All 47 cases revealed hepatomegaly and 9 cases, however, were accompanied by splenomegaly, six cases by emaciation, and for case by anemia. (Fig. 2) Serum alpha-fetoglobulin was highly sensitive and specific for the diagnosis of liver cell carcinoma. The prognosis was good for benign tumors but poor for malignant tumors even after surgical operation. At present, the only recommended method of treatment for primary hepatic tumor in children is early diagnosis followed by surgical resection.