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肝母细胞瘤、早产和脑瘫的关联:病例报告。

The association of hepatoblastoma, prematurity and cerebral palsy: Case reports.

机构信息

Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.

Department of Pediatric Physical Medicine and Rehabilitation, Shirley Ryan AbilityLab, Chicago, IL, USA.

出版信息

J Pediatr Rehabil Med. 2020;13(2):185-188. doi: 10.3233/PRM-190662.

Abstract

PURPOSE

Hepatoblastoma is the most common primary liver tumor in children and has a greater incidence in children with a history of prematurity and very low birth weight. To increase awareness of the association between prematurity and hepatoblastoma for health care providers who treat children with Cerebral Palsy (CP), we present two case reports.

METHODS

Two case reports of premature, very low birth weight infants with hepatoblastoma are described and a literature review of hepatoblastoma in the setting of prematurity and cerebral palsy is performed.

RESULTS

Each patient had a history of 26-28 week prematurity, very low birth weight, and CP. Both presented with worsening constipation and abdominal distension that did not respond to oral medications. Appropriate referrals to the ER were made which lead to a diagnosis of hepatoblastoma. Pediatric rehabilitation was a source of referral for diagnosis in one patient and aided in the rehabilitation course following treatment for both patients.

CONCLUSIONS

Hepatoblastoma is the most common primary liver tumor in children and has an increased incidence in children with a history of prematurity and very low birth weight. Providers who frequently care for the very low birth weight and premature children with CP should be aware of this correlation and include hepatoblastoma in the differential when managing patients with suddenly worsening constipation or abdominal distension. Pediatric physiatrists and other providers for these patients could be a source of referrals and diagnosis leading to timely treatment.

摘要

目的

肝母细胞瘤是儿童中最常见的原发性肝脏肿瘤,在有早产和极低出生体重史的儿童中发病率更高。为了提高治疗脑瘫(CP)儿童的医疗保健提供者对早产与肝母细胞瘤之间关联的认识,我们报告了两例病例。

方法

描述了两例有早产和极低出生体重史的肝母细胞瘤婴儿病例,并对早产儿和脑瘫伴肝母细胞瘤的文献进行了回顾。

结果

每位患者均有 26-28 周早产、极低出生体重和 CP 的病史。两人均出现便秘加重和腹胀,但口服药物治疗无效。适当转至急诊室,最终诊断为肝母细胞瘤。小儿康复科是其中一位患者的转诊来源,并在两位患者的治疗后康复过程中提供帮助。

结论

肝母细胞瘤是儿童中最常见的原发性肝脏肿瘤,在有早产和极低出生体重史的儿童中发病率更高。经常照顾极低出生体重和早产 CP 儿童的医务人员应该意识到这种相关性,并在管理突然出现便秘或腹胀加重的患者时将肝母细胞瘤纳入鉴别诊断。这些患者的小儿物理治疗师和其他医务人员可能是转诊和诊断的来源,从而实现及时治疗。

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