PRIMARY CARCINOMA OF THE LIVER IN INFANCY AND CHILDHOOD

The clinical and pathologic findings in 11 cases of primary hepatic carcinoma occurring in infancy and childhood are presented from the records of the Mayo Clinic from 1905 through 1958. These tumors are rarely encountered in routine practice. All the children were of Caucasian stock and there was no previous history of hepatic disease in 10 cases. In the remaining case the patient had been treated by radiation therapy for hemangioma of the liver 6 years previous to admission to the Clinic. No common factors of possible etiologic significance were present in these patients. Some of the features of previous reports in this field have been described and they are compared and contrasted with the findings in the 11 cases presented. On histologic grounds such tumors of the liver can be divided into two groups: primary carcinomas and mixed tumors. Of the 11 tumors presented seven were considered to be examples of primary carcinomas and four were mixed tumors. The presence of a sarcomatous-like stroma is considered necessary for the diagnosis of a mixed tumor in the absence of osteoid tissue, cartilage, bone or muscle. It is also contended that the presence of osteoid tissue in any amount precludes the diagnosis of primary carcinoma and necessitates a designation of mixed tumor. All the tumors were considered to be malignant and extrahepatic metastasis is described in seven instances. The tumors proved to be fatal within 2 years from the onset of symptoms in 10 cases. In the remaining case, although the child is alive, multiple pulmonary metastatic lesions are present.