Case Report of Congenital Hepatoblastoma With the Onset at 30-Weeks' Gestation

Abstract

This study reports a case of hepatoblastoma with onset at 30-weeks' gestation and rapid growth rate. The postnatal enhanced CT confirmed an intrahepatic mass with a size of 8.5 cm × 6.6 cm and a clear boundary accompanied by uneven enhancement, displacement, and narrow lumen of the hepatic vein due to compression. The alpha-fetoprotein (AFP) at birth was 1,002,632 ng/ml (normal level 48,406 [±34,718] ng/ml). A diagnosis of congenital hepatoblastoma was established based on the imaging and laboratory outcomes. The infant received chemotherapy of Cisplatin-5 fluorouracil-Vincristine (C5V) on the fourth day after birth. After four courses of C5V, a complete tumor resection was performed, and the postoperative pathology was consistent with mixed epithelial and mesenchymal hepatoblastoma. Four more courses of C5V and one course of C5VD (C5V plus doxorubicin) followed the surgery. Infectious diarrhea and acute kidney injury (stage I) occurred during chemotherapy, which recovered after anti-infection and symptomatic treatment. The patient is currently 2 years old and still in complete remission. In this case, the onset of hepatoblastoma was early, and the tumor grew rapidly, resulting in an obvious compression effect. Chemotherapy was started early after birth, and the curative effect was satisfactory, suggesting that the hepatoblastoma based on clinical diagnosis with rapid tumor progression and severe dysfunction of surrounding organs caused by compression should undergo chemotherapy as soon as possible if a pathological diagnosis cannot be obtained temporarily, which also plays an important role in improving the complete resection rate of intraoperative tumor and reducing the recurrence rate of postoperative tumor.

Congenital hepatoblastoma presenting with hepatic arteriovenous fistulas: a case report

“…Therefore, we should be aware of the possibility of liver tumors in newborns with significant AFP elevation. Congenital hepatoblastoma has the characteristics of early onset, rapid progression, easy metastasis, and compression effect ( 12 ). In our case, eye and brain metastases were found, and the family chose to abandon treatment.…”

Evaluation of Serum Fructosamine as Diagnostic Marker of Postoperative Recurrence in the Patients with Breast Cancer

“…Some patients have experienced local tumor cell metastasis and proliferation at the time of treatment, so the survival time of surgical treatment alone is not ideal. Postoperative micrometastasis foci initiate rapid growth mode, and early adjuvant chemotherapy can kill tiny metastatic cancers and residual tumor cells as soon as possible, thereby reducing the recurrence rate and improving survival [18][19][20]. Therefore, predicting the recurrence trend of tumors as early as possible and treating them in a timely manner can significantly improve the prognosis and survival rate of breast cancer patients.…”