Successful right trisegmentectomy for ruptured hepatoblastoma with preoperative transcatheter arterial embolization.
This is the first report of the successful use of percutaneous transcatheter arterial embolization (TAE) in controlling hemorrhage from ruptured hepatoblastoma, allowing early major hepatic resection to be performed safely in a young infant. A 6-month-old girl presented with a huge abdominal mass and was found to have a hepatoblastoma that measured 15 x 10 x 12 cm and arose from the right lobe of her liver on computed tomography (CT) scan examination. The tumor spontaneously ruptured, and she went into shock. TAE with gelfoam cube particles successfully arrested the tumor bleeding and allowed stabilization of her blood pressure with blood transfusion. Right trisegmentectomy was performed 12 hours later. The postoperative course was uneventful. With three courses of cisplatin, vincristine, and 5-fluorouracil after the hepatectomy, the serum alpha-fetoprotein level returned to normal, and the patient has remained well 4 months postoperation.
Chan
K L
KL
Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
Tam
P K
PK
D000792:Angiography; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D018197:Hepatoblastoma / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D002945:Cisplatin; D005472:Fluorouracil