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Review
. 2022 Nov 24:12:1026232.
doi: 10.3389/fonc.2022.1026232. eCollection 2022.

The role of liver transplantation in the care of primary hepatic vascular tumours in children

Affiliations
Review

The role of liver transplantation in the care of primary hepatic vascular tumours in children

Chiara Grimaldi et al. Front Oncol. .

Abstract

Liver transplantation (LT) is the standard of care for many liver conditions, such as end-stage liver diseases, inherited metabolic disorders, and primary liver malignancies. In the latter group, indications of LT for hepatoblastoma and hepatocellular carcinoma evolved and are currently available for many non-resectable cases. However, selection criteria apply, as the absence of active metastases. Evidence of good long-term outcomes has validated the LT approach for managing these malignancies in the context of specialist and multidisciplinary approach. Nevertheless, LT's role in treating primary vascular tumours of the liver in children, both benign and malignant, remains somewhat controversial. The rarity of the different diseases and the heterogeneity of pathological definitions contribute to the controversy and make evaluating the benefit/risk ratio and outcomes quite difficult. In this narrative review, we give an overview of primary vascular tumours of the liver in children, the possible indications and the outcomes of LT.

Keywords: angiosarcoma; children; epithelioid hemangioendothelioma; hemangioma; liver transplantation; liver vascular tumours.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer AL declared a past co-authorship with the authors MC and AM to the handling editor.

Figures

Figure 1
Figure 1
Infantile Hemangioma (IH). The typical pattern of Infantile Hemangioma is represented by proliferation of intercommunicating vascular channels (A) lined by a single layer ef endothelial Glut-1 positive cells (B).
Figure 2
Figure 2
Unifocal hepatic hemangioma (HH) on CT scan (A) and angiography (B).
Figure 3
Figure 3
Neonatal hemangiomatosis with multifocal involvement of the liver.
Figure 4
Figure 4
Algorithm of management for HH.
Figure 5
Figure 5
Angiosarcoma in hepatectomy specimen. Tumour mass of atypical epithelioid and spindle endothelial cells (A), strongly positive on CD 34 immunostaining (B).
Figure 6
Figure 6
Angiosarcoma (HAS) involving the whole liver. Metastases to the spleen and intra-abdominal fluid are evident on TC scan.
Figure 7
Figure 7
Radiological aspect of hepitalial hemangioendothelioma (HEHE) on CT scan.
Figure 8
Figure 8
Epitheliod hemangioendothelioma (HEHE). Proliferation of atypical endothelial cells with a vacoulated appearance (A), positive to CD34 immunostaining (B), in a myxohyline stroma.
Figure 9
Figure 9
Algorithm of management of malignant vascular tumours. HAS, hepatic angiosarcoma, HEHE, hepatic epitelioid hemangioendotelioma, CT, chemotherapy.

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