Hepatoblastoma metastatic to the right atrium responding to chemotherapy alone.
An 18-month-old boy presented with abdominal pain and distension. On physical examination there was a 10 x 7-cm mass in the right upper abdominal quadrant. His alpha-fetoprotein level was 175,000 IU/mL. Abdominal magnetic resonance findings revealed hepatomegaly with multiple tumor masses involving nearly all the segments of the liver (PRETEXT IV). The tumor extended through the inferior vena cava and filled 2/3 of the right atrium. Echocardiography revealed normal cardiac function. Histopathologic findings after liver biopsy were consistent with hepatoblastoma. After 6 courses of chemotherapy including cisplatin and doxorubicin (PLADO, SIOPEL protocol), the cardiac tumor regressed completely. The patient's primary tumor was then fully resected; no cardiac surgery was performed. After surgery the AFP level was 4 IU/mL and echocardiography revealed normal cardiac function with no residual tumor. The patient has been in remission for 31 months postdiagnosis.
Kesik
Vural
V
Department of Pediatric Oncology, Gulhane Military Medical Academy, School of Medicine, Etlik, Ankara, Turkey. vural73@yahoo.com
Yozgat
Yilmaz
Y
Sari
Erkan
E
Kocaoğlu
Murat
M
Kismet
Erol
E
Koseoglu
Vedat
V
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D004562:Electrocardiography; D006325:Heart Atria / Q000473:pathology*; D006338:Heart Neoplasms / Q000188:drug therapy / Q000556:secondary*; D018197:Hepatoblastoma / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D012074:Remission Induction / Q000379:methods; D014682:Vena Cava, Inferior / Q000473:pathology
D004317:Doxorubicin; D002945:Cisplatin