Role of Chemoembolization as a Rescue Treatment for Recurrence of Resected Hepatoblastoma in Adult Patients

Introduction: Hepatoblastoma is the most common malignant liver tumor in children, but it is extremely rare in adults. Materials and methods: A 33-year-old man was admitted with nausea, vomiting, weight loss, and right upper quadrant pain. A preoperative magnetic resonance imaging showed a nodular hepatic lesion infiltrating the lesser curvature of the stomach. A left hepatectomy and a subtotal gastrectomy were performed. The histological diagnosis was hepatoblastoma. A recurrence in the right lobe was seen. Results: Three cycles of transcatheter arterial chemoembolization (TACE) were performed 40, 70, and 130 days after surgery. No sign of recurrence was present at the time of the second chemoembolization. Conclusion: The TACE was well tolerated by the patient and controlled the recurrence. The patient survived 11 months after recurrence of disease and died 1 year after the liver resection. The use of TACE to treat the hepatic recurrence was never described.

[1]  H. Mildenberger,et al.  The influence of preoperative chemotherapy and surgical technique in the treatment of hepatoblastoma--a report from the German Cooperative Liver Tumour Studies HB 89 and HB 94. , 2002, European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie.

[2]  R. Carter Hepatoblastoma in the adult , 1969, Cancer.

[3]  M. Fukuzawa,et al.  Transcatheter arterial chemoembolization in the treatment of hepatoblastoma. , 1998, Journal of pediatric surgery.

[4]  N. Kasthuri,et al.  Malignant hepatic tumours in children: incidence, clinical features and aetiology. , 1990, Paediatric and perinatal epidemiology.

[5]  A. Cantor,et al.  Chemotherapy can convert unresectable hepatoblastoma. , 1992, Journal of pediatric surgery.

[6]  A. Carceller,et al.  Surgical resection and chemotherapy improve survival rate for patients with hepatoblastoma. , 2001, Journal of pediatric surgery.

[7]  G. Tiao,et al.  The current management of hepatoblastoma: a combination of chemotherapy, conventional resection, and liver transplantation. , 2005, The Journal of pediatrics.

[8]  H. Higashihara,et al.  Adult hepatoblastoma: case report and review of the literature. , 1995, The Australian and New Zealand journal of surgery.

[9]  G. Mieli-Vergani,et al.  Improved outcome for children with hepatoblastoma , 1995, The British journal of surgery.

[10]  F. Kondo,et al.  Hepatoblastoma in an adult A case report and clinical review of literatures. , 2004, Hepatology research : the official journal of the Japan Society of Hepatology.

[11]  S. Fan,et al.  Locoregional Therapies for Hepatocellular Carcinoma: A Critical Review From the Surgeon’s Perspective , 2002, Annals of surgery.

[12]  D. Tashjian,et al.  Preoperative chemoembolization for unresectable hepatoblastoma , 2002, Pediatric Surgery International.

[13]  M. Ozaki,et al.  Evaluation of liver tumors using fluorine-18-fluorodeoxyglucose PET: characterization of tumor and assessment of effect of treatment. , 1992, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[14]  G. Perilongo,et al.  Effectiveness and toxicity of cisplatin and doxorubicin (PLADO) in childhood hepatoblastoma and hepatocellular carcinoma: a SIOP pilot study. , 1991, Medical and pediatric oncology.

[15]  R. Colombari,et al.  Hepatoblastoma in adult age: a report of two cases. , 1996, Hepato-gastroenterology.

[16]  D. Gerber,et al.  Intrahepatic chemoembolization in unresectable pediatric liver malignancies , 2000, Pediatric Radiology.

[17]  S. Thung,et al.  Malignant liver tumors. , 2002, Clinics in liver disease.

[18]  T. Vogl,et al.  Preoperative evaluation of malignant liver tumors: comparison of unenhanced and SPIO (Resovist)-enhanced MR imaging with biphasic CTAP and intraoperative US , 2003, European Radiology.

[19]  D. Gümürdülü,et al.  Fine Needle Aspiration Cytology of Hepatoblastoma , 1998, Acta Cytologica.

[20]  G. Perilongo,et al.  SIOPEL trials using preoperative chemotherapy in hepatoblastoma. , 2000, The Lancet. Oncology.

[21]  K. Ishak,et al.  Tumors of the liver and intrahepatic bile ducts , 2001 .