A systematic surgical approach to hepatoblastoma with intracardiac extension

Abstract

Hepatoblastoma is very uncommon in children, and intracardiac extension is rare. The SIOPEL-4 regime for metastatic hepatoblastoma has extended the surgical options with good results. We successfully treated a boy aged 2 years and 9 months with hepatoblastoma, using a multidisciplinary surgical strategy involving an extended left hepatectomy, left adrenalectomy, biopsy of the paraaortic and coeliac lymph nodes, and resection of the inferior vena caval-right atrial extension of the hepatoblastoma, under cardiopulmonary bypass and deep hypothermia.

Metastatic Progression of an Aggressive Hepatoblastoma Involving the Left Atrium and Ventricle

“…Cardiac metastases of hepatoblastoma are extremely rare (0.67% to 3% of cases) [3,4]. Previously, metastases to the right atrium via the inferior vena cava, to the right ventricle associated with the pulmonary artery, and to the left atrium via the pulmonary vein have been reported [5][6][7].…”