Resection after intraarterial chemotherapy of a hepatoblastoma originating in the caudate lobe.
A rare case of hepatoblastoma originating in the caudate lobe was treated successfully with intraarterial chemotherapy followed by extensive lobectomy of the left side of the liver. Imaging modalities demonstrated a solitary huge tumor, initially inoperable, occupying almost the entire liver in a 4-month-old female infant. Transcatheter intrahepatic arterial chemotherapy with 10 mg doxorubicin, 20 mg cisplatin, and 3 ml Lipiodol, repeated twice at a 1-month interval, led to a remarkable reduction in tumor size and thereby made it resectable. The volume ratio between the intact hepatic parenchyma and the tumor changed from 1:1.70 to 1:0.13, as assessed by serial computed tomography scans, and the patient's initial alpha-fetoprotein level of 223,210 ng/ml declined to 53 ng/ml. The present case is the first in the literature, to our knowledge, of a resected hepatoblastoma in the caudate lobe. Clinical details of the tumor and surgical issues are discussed.
Takayama
T
T
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Makuuchi
M
M
Takayasu
K
K
LeThai
B
B
Ohyama
H
H
Yamazaki
S
S
Hasegawa
H
H
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D007261:Infusions, Intra-Arterial; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed
D007459:Iodized Oil; D004317:Doxorubicin; D002945:Cisplatin