title: Successful treatment of unresectable advanced hepatoblastoma: living liver transplantation after surgical removal of lung metastasis.
abstract: Hepatoblastoma is a rare malignant tumor of the liver in children. Intensive combination chemotherapy has increased the number of surgically resectable cases and improved prognosis markedly. However, unresectable cases and cases with residual metastasis, including lung metastases, have a poor prognosis. In these refractory cases, treatment strategy has not been established. On the other hand, living liver transplantation has been shown to be effective in cases of advanced hepatoblastoma, but its effectiveness in cases with residual distant metastases after chemotherapy remains unclear. We report one successful case of advanced unresectable hepatoblastoma with multiple lung metastases. Intensive chemotherapy consisting of high-dose chemotherapy with autologous hematopoietic stem cell transplantation was not effective. We performed living liver transplantation after surgical resection of residual lung metastases, which were histologically viable. After liver transplantation, the level of tumor marker decreased gradually. The patient experienced no severe complications. This case suggested that living liver transplantation could be effective in cases of advanced refractory hepatoblastoma after control of distant metastases.
authors.affiliation: Department of Pediatrics, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan. miyamu@md.okayama-u.ac.jp
authors.forename: Takako
authors.initials: T
authors.lastname: Miyamura
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Yoshida
authors.forename: Takahito
authors.initials: T
authors.lastname: Yagi
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Matsukawa
authors.forename: Kousuke
authors.initials: K
authors.lastname: Chayama
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ishida
authors.forename: Kana
authors.initials: K
authors.lastname: Washio
authors.forename: Naoto
authors.initials: N
authors.lastname: Morishita
authors.forename: Megumi
authors.initials: M
authors.lastname: Oda
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Morishima
mesh_terms: D002675:Child, Preschool; D006503:Hepatic Veins / Q000473:pathology; D018197:Hepatoblastoma / Q000601:surgery* / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery* / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008175:Lung Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D008297:Male; D009362:Neoplasm Metastasis; D011379:Prognosis; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome