Purpose <p>Neonatal liver tumors, although rare, can cause life-threatening conditions immediately after birth, requiring urgent surgical intervention. We retrospectively reviewed neonatal liver tumors requiring early postnatal hepatectomy to identify the factors necessitating early surgical intervention.</p> Methods <p>We retrospectively analyzed neonatal liver tumors that required surgical resection in the early postnatal period at our institution between 1980 and 2021. Clinical records were reviewed for gestational age, birth weight, tumor characteristics, surgical procedures, and perioperative complications.</p> Results <p>Seven patients were identified; four were diagnosed prenatally and three postnatally. The delivery modes included vaginal (<i>n</i> = 4) and cesarean (<i>n</i> = 3) births. The median gestational age, birth weight, tumor size, and age at surgery were 38 (range, 37–40) weeks, 3152 (2564–3898) g, 10 (2.5–12) cm, and 6 (0–62) days, respectively. The final diagnoses included hepatoblastoma (<i>n</i> = 3), hemangioma (<i>n</i> = 2), mesenchymal hamartoma (<i>n</i> = 1), and focal nodular hyperplasia (<i>n</i> = 1). Six patients presented with life-threatening systemic compromise due to tumor-related mass effect, rupture, hemorrhage, or metabolic derangement. Surgery-related complications occurred in three patients, including tumor lysis syndrome.</p> Conclusions <p>Neonatal liver tumors can precipitate rapidly progressive and life-threatening systemic conditions. Although early postnatal hepatectomy carries substantial risks, timely surgical decision-making with anticipation of tumor-related complications can be life-saving and thus enable favorable long-term outcomes.</p>

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Neonatal liver tumors requiring early postnatal hepatectomy: A retrospective review of seven cases

  • Hidehito Usui,
  • Ryo Takahashi,
  • Satoshi Tanaka,
  • Rento Morishima,
  • Kazuki Shirane,
  • Takafumi Kondo,
  • Kyoko Mochizuki,
  • Dai Keino,
  • Kumiko Nozawa,
  • Mio Tanaka,
  • Katsuaki Toyoshima,
  • Masakatsu Yanagimachi,
  • Hiroaki Goto,
  • Masato Shinkai,
  • Norihiko Kitagawa,
  • Aya Saito

摘要

Purpose

Neonatal liver tumors, although rare, can cause life-threatening conditions immediately after birth, requiring urgent surgical intervention. We retrospectively reviewed neonatal liver tumors requiring early postnatal hepatectomy to identify the factors necessitating early surgical intervention.

Methods

We retrospectively analyzed neonatal liver tumors that required surgical resection in the early postnatal period at our institution between 1980 and 2021. Clinical records were reviewed for gestational age, birth weight, tumor characteristics, surgical procedures, and perioperative complications.

Results

Seven patients were identified; four were diagnosed prenatally and three postnatally. The delivery modes included vaginal (n = 4) and cesarean (n = 3) births. The median gestational age, birth weight, tumor size, and age at surgery were 38 (range, 37–40) weeks, 3152 (2564–3898) g, 10 (2.5–12) cm, and 6 (0–62) days, respectively. The final diagnoses included hepatoblastoma (n = 3), hemangioma (n = 2), mesenchymal hamartoma (n = 1), and focal nodular hyperplasia (n = 1). Six patients presented with life-threatening systemic compromise due to tumor-related mass effect, rupture, hemorrhage, or metabolic derangement. Surgery-related complications occurred in three patients, including tumor lysis syndrome.

Conclusions

Neonatal liver tumors can precipitate rapidly progressive and life-threatening systemic conditions. Although early postnatal hepatectomy carries substantial risks, timely surgical decision-making with anticipation of tumor-related complications can be life-saving and thus enable favorable long-term outcomes.