title: Hepatoblastoma.
abstract: Hepatoblastoma is the most common primary malignant hepatic tumor of infancy and childhood, occurring predominantly in the first two years of life. The management of hepatoblastoma has changed markedly over the last 3 decades; neoadjuvant chemotherapy is now standard, particularly in unresectable tumors resulting in considerable preoperative tumor shrinkage and sometimes near total ablation of the tumor. A 20 month old infant was incidentally found to have a 7.6cm right sided retroperitoneal tumor on routine screening ultrasonography for left ureteral stenosis. Serum alpha fetoprotein was elevated. Biopsy revealed hepatoblastoma, mixed epithelial and embryonal type without mesenchymal elements. He underwent neoadjuvant chemotherapy. Although the tumor had decreased considerably in size, close proximity to major vascular structures precluded safe resection. Liver transplantation was performed; the explanted liver showed complete tumor necrosis with no residual malignancy. The postoperative course was uncomplicated and he is continuing on sixth cycle of chemotherapy.
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, United States.
authors.forename: Divya
authors.initials: D
authors.lastname: Sharma
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Indiana University School of Medicine, United States.
authors.forename: Girish
authors.initials: G
authors.lastname: Subbarao
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, United States. Electronic address: rsaxena@iupui.edu.
authors.forename: Romil
authors.initials: R
authors.lastname: Saxena
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D018197:Hepatoblastoma / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D020360:Neoadjuvant Therapy
keywords: Mixed epithelial mesenchymal hepatoblastoma; Pure fetal hepatoblastoma; Small cell undifferentiated hepatoblastoma; Teratoid hepatoblastoma