title: Use of gemcitabine with multi-stage surgical resection as successful second-line treatment of metastatic pancreatoblastoma.
abstract: Pancreatoblastoma is a rare pediatric pancreatic malignancy. It confers a worse prognosis if there is metastatic or unresectable disease. We report a case of a 12-year-old boy who presented with pancreatoblastoma of the head of the pancreas with multiple intrahepatic metastases. We successfully treated him using aggressive chemotherapy, multi-stage surgery, and gemcitabine chemotherapy, which has not been described as treatment for pancreatoblastoma. Rare childhood malignancies such as pancreatoblastoma require a coordinated, multidisciplinary approach and frequent reassessment of therapeutic interventions. Complete surgical resection is important for cure and may require complex, aggressive, multiple-stage surgical procedures with concurrent or novel chemotherapy.
authors.affiliation: Department of Pediatrics, Division of Pediatric Hematology, Oncology and Palliative Care, Stollery Children's Hospital, Edmonton, AB, Canada. mark.belletrutti@albertahealthservices.ca
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Belletrutti
authors.forename: David
authors.initials: D
authors.lastname: Bigam
authors.forename: Ravi
authors.initials: R
authors.lastname: Bhargava
authors.forename: Paul
authors.initials: P
authors.lastname: Grundy
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000556:secondary / Q000628:therapy*; D011379:Prognosis; D016879:Salvage Therapy; D014057:Tomography, X-Ray Computed; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine