Abstract
Purpose
Adult hepatoblastoma is rare and the prognosis is extremely poor. Although surgery offers the only chance for cure, it often recurs even after complete resection. To date, no therapeutic strategy has been established. We report here a rare case of adult hepatoblastoma successfully treated with multimodal treatment.
Methods
A 25-year-old female who had been suffering from right hypochondriac pain was referred to our hospital. Preoperative diagnosis was adult hepatoblastoma. Huge liver tumor was initially deemed unresectable. An intensive chemotherapy including arterial chemoinfusion using interventional–radiological technique resulted in a remarkable tumor reduction. Furthermore, lung metastasis that had later appeared was completely treated with additional chemotherapy. Then she underwent curative surgery at 8 months after initial treatment.
Results
The pathological diagnosis was well-differentiated hepatoblastoma. The postoperative course was uneventful and she received short-course adjuvant chemotherapy. She survived for over 4 years after diagnosis.
Conclusions
To our knowledge, this is the first report demonstrating long-term survival of a patient with initially unresectable adult hepatoblastoma. Our new therapeutic strategy may provide new insights into the treatment of this fatal disease.
Similar content being viewed by others
References
Litten JB, Tomlinson GE (2008) Liver tumors in children. Oncologist 13:812–820
Sasaki F, Matsunaga T, Iwafuchi M, Hayashi Y, Ohkawa H, Ohira M, Okamatsu T, Sugito T, Tsuchida Y, Toyosaka A, Nagahara N, Nishihira H, Hata Y, Uchino J, Misugi K, Ohnuma N (2002) Outcome of hepatoblastoma treated with the JPLT-1 (Japanese Study Group for Pediatric Liver Tumor) Protocol-1: a report from the Japanese Study Group for Pediatric Liver Tumor. J Pediatr Surg 37:851–856
Remes-Troche JM, Montano-Loza A, Meza-Junco J, Garcia-Leiva J, Torre-Delgadillo A (2006) Hepatoblastoma in adult age. A case report and literature review. Ann Hepatol 5:179–181
Yamazaki M, Ryu M, Okazumi S, Kondo F, Cho A, Okada T, Takayama W, Kawashima T, Furuki A, Hirata T (2004) Hepatoblastoma in an adult A case report and clinical review of literatures. Hepatol Res 30:182–188
Ahn HJ, Kwon KW, Choi YJ, Kim HJ, Hong SP, Oh D, Chung JS (1997) Mixed hepatoblastoma in an adult—a case report and literature review. J Korean Med Sci 12:369–373
Ke HY, Chen JH, Jen YM, Yu JC, Hsieh CB, Chen CJ, Liu YC, Chen TW, Chan DC (2005) Ruptured hepatoblastoma with massive internal bleeding in an adult. World J Gastroenterol 11:6235–6237
Bortolasi L, Marchiori L, Dal Dosso I, Colombari R, Nicoli N (1996) Hepatoblastoma in adult age: a report of two cases. Hepatogastroenterology 43:1073–1078
Harada T, Matsuo K, Kodama S, Higashihara H, Nakayama Y, Ikeda S (1995) Adult hepatoblastoma: case report and review of the literature. Aust NZ J Surg 65:686–688
Mukhopadhyay P, Kundu SS, Banerjee A, Mukherjee A (2007) Adult hepatoblastoma in a female Down’s. J Assoc Physicians India 55:242–243
Kasper HU, Longerich T, Stippel DL, Kern MA, Drebber U, Schirmacher P (2005) Mixed hepatoblastoma in an adult. Arch Pathol Lab Med 129:234–237
Inagaki M, Yagi T, Urushihara N, Shima Y, Sadamori H, Takakura N, Tanaka N, Oda M (2001) Successfully resected hepatoblastoma in a young adult with chronic hepatitis B: report of a case. Eur J Gastroenterol Hepatol 13:981–984
Reddy KS, Karak PK, Sharma S, Rao RC, Vijayaraghavan M, Sahni P (1997) Epithelial hepatoblastoma in a middle aged woman. Trop Gastroenterol 18:163–164
Parada LA, Bardi G, Hallen M, Hagerstrand I, Tranberg KG, Mitelman F, Johansson B (1997) Cytogenetic abnormalities and clonal evolution in an adult hepatoblastoma. Am J Surg Pathol 21:1381–1386
Kuniyasu H, Yasui W, Shimamoto F, Fujii K, Nakahara M, Asahara T, Dohi K, Tahara E (1996) Hepatoblastoma in an adult associated with c-met proto-oncogene imbalance. Pathol Int 46:1005–1010
Kacker LK, Khan EM, Gupta R, Kapoor VK, Pandey R, Gupta RK, Saraswat VA (1995) Hepatoblastoma in an adult with biliary obstruction and associated portal venous thrombosis. HPB Surg 9:47–49
Misra GC, Mansharamani GG, Deewan R, Jayaraman G (1988) Mixed hepatoblastoma in a young adult. J Assoc Physicians India 36:169–170
Bhatnagar A, Pathania OP, Champakam NS (1987) Hepatoblastoma in an adult female. Indian J Gastroenterol 6:125–126
Schnater JM, Aronson DC, Plaschkes J, Perilongo G, Brown J, Otte JB, Brugieres L, Czauderna P, MacKinlay G, Vos A (2002) Surgical view of the treatment of patients with hepatoblastoma: results from the first prospective trial of the International Society of Pediatric Oncology Liver Tumor Study Group. Cancer 94:1111–1120
Taguchi T (1994) Chemo-occlusion for the treatment of liver cancer. A new technique using degradable starch microspheres. Clin Pharmacokinet 26:275–291
Furuse J, Ishii H, Satake M, Onaya H, Nose H, Mikami S, Sakai H, Mera K, Maru Y, Yoshino M (2003) Pilot study of transcatheter arterial chemoembolization with degradable starch microspheres in patients with hepatocellular carcinoma. Am J Clin Oncol 26:159–164
Ninane J, Perilongo G, Stalens JP, Guglielmi M, Otte JB, Mancini A (1991) Effectiveness and toxicity of cisplatin and doxorubicin (PLADO) in childhood hepatoblastoma and hepatocellular carcinoma: a SIOP pilot study. Med Pediatr Oncol 19:199–203
Ortega JA, Krailo MD, Haas JE, King DR, Ablin AR, Quinn JJ, Feusner J, Campbell JR, Lloyd DA, Cherlow J et al (1991) Effective treatment of unresectable or metastatic hepatoblastoma with cisplatin and continuous infusion doxorubicin chemotherapy: a report from the Childrens Cancer Study Group. J Clin Oncol 9:2167–2176
Okuda K, Tanaka M, Shibata J, Ando E, Ogata T, Kinoshita H, Eriguchi N, Aoyagi S, Tanikawa K (1999) Hepatic arterial infusion chemotherapy with continuous low dose administration of cisplatin and 5-fluorouracil for multiple recurrence of hepatocellular carcinoma after surgical treatment. Oncol Rep 6:587–591
Ijichi O, Ishikawa S, Shinkoda Y, Tanabe T, Okamoto Y, Takamatsu H, Inomata Y, Kawano Y (2006) Response of heavily treated and relapsed hepatoblastoma in the transplanted liver to single-agent therapy with irinotecan. Pediatr Transplant 10:635–638
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nakamura, S., Sho, M., Kanehiro, H. et al. Adult hepatoblastoma successfully treated with multimodal treatment. Langenbecks Arch Surg 395, 1165–1168 (2010). https://doi.org/10.1007/s00423-010-0630-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00423-010-0630-5