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Title: Resectable hepatoblastoma with tumor thrombus extending into the right atrium after chemotherapy: A case report
Authors: Endo, Kosuke
Yokoi, Akiko
Mishima, Yasuhiko
Tamaki, Akihiko
Takemoto, Junkichi
Morita, Keiichi
Iwade, Tamaki
Okata, Yuichi
Fukuzawa, Hiroaki
Bitoh, Yuko
Hasegawa, Tomomi
Yoshida, Makiko
Akasaka, Yoshinobu
Okajima, Hideaki
Oshima, Yoshihiro
Maeda, Kosaku
Uemoto, Shinji
Author's alias: 遠藤, 耕介
岡島, 英明
上本, 伸二
Keywords: Extracorporeal circulation
Chemotherapy
Hepatoblastoma
Tumor thrombus
Resection
Issue Date: Apr-2016
Publisher: Elsevier Inc.
Journal title: Journal of Pediatric Surgery Case Reports
Volume: 7
Start page: 20
End page: 22
Abstract: Hepatoblastoma with intraatrial tumor thrombus is relatively rare. We report a case of hepatoblastoma with tumor thrombus extending into the right atrium, which responded well to chemotherapy and was resected using extracorporeal circulation. A 4-year-old girl was referred to our hospital because of abdominal distention and tenderness. A computed tomography (CT) scan showed a large tumor occupying the left 3 segments of the liver with tumor thrombus extending into the right atrium. There was also a small intrahepatic metastasis in the right lobe of the liver. She was diagnosed with hepatoblastoma on the basis of the results of open biopsy. Neoadjuvant chemotherapy with an intense CDDP-based regimen was performed. The tumor responded well to chemotherapy, and intrahepatic metastasis became undetectable on CT scan, although the tumor thrombus remained in the right atrium. After 7 courses of chemotherapy, we performed resection using extracorporeal circulation. The postoperative course was uneventful, and adjuvant chemotherapy was started 10 days after the operation. Her serum alpha-fetoprotein (AFP) level decreased to the normal range, and she was free of disease for 1 year after the operation. Tumor resection using extracorporeal circulation can be performed safely and is justified in patients with intraatrial tumor thrombus.
Rights: © 2016 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/).
URI: http://hdl.handle.net/2433/215116
DOI(Published Version): 10.1016/j.epsc.2016.01.004
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