title: Liver transplantation as a potentially lifesaving measure in neuroblastoma stage 4S.
abstract: Neuroblastoma (NBL) stage 4s is an incompletely understood phenomenon with variable clinical course. While the majority of patients may undergo spontaneous regression and achieve complete resolution without intensive therapy, a small proportion is at increased risk of developing secondary complications. One such situation is liver insufficiency due to diffuse metastases. We report a patient suffering from NBL 4S who required double lifesaving liver transplantation. Abdominal and respiratory complications due to hepatomegaly are crucial determinants for treatment intensity and duration in 4S NBL [1,2] . We provide an algorithm in order to facilitate the clinical decision when dealing with similar potentially life-threatening events.
authors.affiliation: a Research Institute, Children's Cancer Center Hamburg , Hamburg , Germany.
authors.forename: Till
authors.initials: T
authors.lastname: Holsten
authors.affiliation: b Department of Pediatric Surgery and Urology , Children's Hospital Augsburg , Augsburg , Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Schuster
authors.affiliation: c Department of Pediatrics , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
authors.forename: Enke
authors.initials: E
authors.lastname: Grabhorn
authors.affiliation: d Department of Pediatric Hematology and Oncology , University Children's Hospital , Cologne , Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hero
authors.affiliation: e Children's Hospital Augsburg, Swabian Children's Cancer Center , Augsburg , Germany.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Frühwald
mesh_terms: D000328:Adult; D000465:Algorithms; D003657:Decision Making; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000601:surgery*
keywords: HACE; liver transplantation; neuroblastoma; stage 4S