Aggressive hepatectomy for complete remission of metastatic germ cell tumor following chemotherapy: report of a case.
A 12-year-old girl presented with hemoperitoneum caused by disseminated liver tumors accompanying a retroperitoneal germ cell tumor and was rescued by transcatheter hepatic arterial embolization. Following systemic chemotherapy, the liver tumors decreased in size and number, although the retroperitoneal tumor was resistant to therapy. We simultaneously resected the retroperitoneal tumor, and the liver lesions by extended left lobectomy combined with resection of the three major (right, middle, and left) hepatic veins, while preserving the inferior right hepatic vein. The postoperative course was uneventful, and liver regeneration evaluated by serial computed tomography was almost completed by three months following surgery. Pathological examination of the resected tumors revealed benign (mature) teratomas. Since complete removal of tumors critically influences the outcome in patients with mature teratoma, aggressive surgery is advocated for extensive tumors. The present case clearly demonstrated that extended hepatectomy with resection of three major hepatic veins is feasible and provides an opportunity for achieving complete remission in patients with metastatic germ cell tumor of the liver.
Yokoi
Yoshihiro
Y
Second Department of Surgery, Hamamatsu University School of Medicine, 3600 Hanada-cho, Hamamatsu 431-3192, Japan.
Suzuki
Shohachi
S
Baba
Satoshi
S
Ohzeki
Takehiko
T
Yajima
Shuhei
S
Okada
Shuichi
S
Okumura
Takuya
T
Konno
Hiroyuki
H
Nakamura
Satoshi
S
D002648:Child; D004621:Embolization, Therapeutic; D005260:Female; D018237:Germinoma / Q000150:complications / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D006465:Hemoperitoneum / Q000209:etiology / Q000628:therapy; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D012074:Remission Induction; D012186:Retroperitoneal Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*