Review Article Benign paediatric liver tumours: The radiological maze demystified

Poonam Sherwani, Devasenathipathy Kandasamy, Raju Sharma, Prabudh Goel, Manisha Jana, Nellai Krishnan

South African Journal of Radiology | Vol 28, No 1 | a2726 | DOI: https://doi.org/10.4102/sajr.v28i1.2726 | © 2024 Poonam Sherwani, Devasenathipathy Kandasamy, Raju Sharma, Prabudh Goel, Manisha Jana, Nellai Krishnan | This work is licensed under CC Attribution 4.0
Submitted: 30 May 2023 | Published: 12 February 2024

About the author(s) Poonam Sherwani, Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, India
Devasenathipathy Kandasamy, Department of Radiodiagnosis, All India Institute of Medical Sciences, Delhi, India
Raju Sharma, Department of Radiodiagnosis, All India Institute of Medical Sciences, Delhi, India
Prabudh Goel, Department of Paediatric Surgery, All India Institute of Medical Sciences, Delhi, India
Manisha Jana, Department of Radiodiagnosis, All India Institute of Medical Sciences, Delhi, India
Nellai Krishnan, Department of Paediatric Surgery, All India Institute of Medical Sciences, Delhi, India

Abstract

The trajectory from the clinical identification of a benign liver mass to establishing a precise diagnosis is perplexing and arduous. Related contributory factors are that such lesions are encountered infrequently and that there is a nonavailability of dedicated paediatric radiologists in the developing world. The objective of this study was to review the spectrum of benign liver lesions in children and their typical imaging features. Cross-sectional imaging of all paediatric patients (< 18 years) with liver lesions (single and multiple) performed in the institute from 01 January 2018 to 01 January 2019 as well as those acquired at outside institutions and referred to the institute for management was included. Ultrasound was done as the first line of investigation in all the cases with suspicious liver masses and retrospectively performed in referral cases in whom CT or MRI was already done. Images were analysed by two senior radiologists. Most of the cases were diagnosed based on clinical, biochemical and imaging findings, and biopsy was only performed in equivocal cases. Most of the benign liver lesions in the paediatric age group were hepatic haemangioma and mesenchymal hamartomas. A simplified clinical-radiologic paradigm should be established for benign liver lesions in children to assist in reaching the correct diagnosis.

Contribution: The article demonstrates the salient radiological findings of various benign liver lesions in the paediatric age group and the role of demographic, clinical and biochemical findings, which plays a substantial role in the diagnosis and avoids unnecessary biopsies.

Keywords

benign; liver; infantile hepatic haemangioma; mesenchymal hamartoma; adenoma; focal nodular hyperplasia.

Sustainable Development Goal

Goal 5: Gender equality

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