Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2015; 21(28): 8541-8561
Published online Jul 28, 2015. doi: 10.3748/wjg.v21.i28.8541
Benign liver tumors in pediatric patients - Review with emphasis on imaging features
Liliana Chiorean, Xin-Wu Cui, Andrea Tannapfel, Doris Franke, Martin Stenzel, Wojciech Kosiak, Dagmar Schreiber-Dietrich, Jörg Jüngert, Jian-Min Chang, Christoph F Dietrich
Liliana Chiorean, Xin-Wu Cui, Dagmar Schreiber-Dietrich, Jian-Min Chang, Christoph F Dietrich, Sino-German Research Center of Ultrasound in Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, Henan Province, China
Liliana Chiorean, Christoph F Dietrich, Medical Department 2, Caritas-Krankenhaus, Uhlandstr. 7, D-97980 Bad Mergentheim, Germany
Andrea Tannapfel, Institut für Pathologie, Ruhruniversität Bochum, Georgius Agricola Stiftung Ruhr, Bürkle-de-la-Camp-Platz 1 44789 Bochum, Germany
Doris Franke, Department of Paediatric Kidney, Liver and Metabolic Diseases, Children's Hospital, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
Jörg Jüngert, Department of Pediatrics, University of Erlangen, Loschgestrasse 15, 91054 Erlangen, Germany
Martin Stenzel, Department of Pediatric Radiology, University of Freiburg, Friedrichstr. 39, 79098 Freiburg, Germany
Wojciech Kosiak, Department of Pediatric Hematology and Oncology, Medical University of Gdansk, 80-210 Gdańsk, Poland
Author contributions: Dietrich CF designed and conceived the paper; Chiorean L, Cui XW, Tannapfel A, Franke D, Stenzel M, Kosiak W, Schreiber-Dietrich D, Jüngert J, Chang JM and Dietrich CF analyzed the literature data; Chiorean L provided the first draft of the manuscript, which was discussed and revised critically for intellectual content by Cui XW, Tannapfel A, Franke D, Stenzel M, Kosiak W, Schreiber-Dietrich D, Jüngert J, Chang JM, and Dietrich CF; all authors discussed the statement and conclusions, and approved the final version to be published.
Conflict-of-interest statement: None to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Christoph F Dietrich, Professor of Medicine, Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Jianshe East Road No. 1, Zhengzhou 450052, China. christoph.dietrich@ckbm.de
Telephone: +86-371-66913150 Fax: +86-371-66913150
Received: January 19, 2015
Peer-review started: January 20, 2015
First decision: March 26, 2015
Revised: April 16, 2015
Accepted: May 20, 2015
Article in press: May 21, 2015
Published online: July 28, 2015
Abstract

Benign hepatic tumors are commonly observed in adults, but rarely reported in children. The reasons for this remain speculative and the exact data concerning the incidence of these lesions are lacking. Benign hepatic tumors represent a diverse group of epithelial and mesenchymal tumors. In pediatric patients, most benign focal liver lesions are inborn and may grow like the rest of the body. Knowledge of pediatric liver diseases and their imaging appearances is essential in order to make an appropriate differential diagnosis. Selection of the appropriate imaging test is challenging, since it depends on a number of age-related factors. This paper will discuss the most frequently encountered benign liver tumors in children (infantile hepatic hemangioendothelioma, mesenchymal hamartoma, focal nodular hyperplasia, nodular regenerative hyperplasia, and hepatocellular adenoma), as well as a comparison to the current knowledge regarding such tumors in adult patients. The current emphasis is on imaging features, which are helpful not only for the initial diagnosis, but also for pre- and post-treatment evaluation and follow-up. In addition, future perspectives of contrast-enhanced ultrasound (CEUS) in pediatric patients are highlighted, with descriptions of enhancement patterns for each lesion being discussed. The role of advanced imaging tests such as CEUS and magnetic resonance imaging, which allow for non-invasive assessment of liver tumors, is of utmost importance in pediatric patients, especially when repeated imaging tests are needed and radiation exposure should be avoided.

Keywords: Focal liver lesions, Benign, Pediatric, Children, Ultrasound

Core tip: Focal liver lesions (FLL) are commonly observed in adults, but rarely reported in children. The reasons for this remain speculative. Most benign focal liver lesions are inborn and may grow like the rest of the body. The current paper deals with FLLs in pediatric patients, as well as a comparison to the current knowledge regarding such tumors in adult patients.