Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A case of recurrent hepatoblastoma : lung, heart and brain metastasis

폐, 심장, 뇌에 전이되어 재발된 간모세포종 1례

  • Park, Sun Mi (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Choe, Byung Kyu (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Kim, Yeo Hyang (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Kim, Heung Sik (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Kwon, Tae Chan (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Lee, Hee Jung (Department of Radiology, Keimyung University School of Medicine)
  • 박선미 (계명대학교 의과대학 소아과학교실) ;
  • 최병규 (계명대학교 의과대학 소아과학교실) ;
  • 김여향 (계명대학교 의과대학 소아과학교실) ;
  • 김흥식 (계명대학교 의과대학 소아과학교실) ;
  • 권태찬 (계명대학교 의과대학 소아과학교실) ;
  • 이희정 (계명대학교 의과대학 방사선과학교실)
  • Received : 2005.11.14
  • Accepted : 2006.01.20
  • Published : 2006.06.15
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Abstract

Hepatoblastoma is a hepatic tumor predominantly occurring in children. The usual site of metastasis is the lung. There are only several reports worldwide on the distant metastasis of hepatoblastoma to the central nervous system in children. Only one reported case showed survival of a patient after multiple resections of a recurrent brain lesion. Involvement of the cardiovascular system has been reported in the medical literature. Lesions almost always involve the right-side of the heart. We report a case of recurrent hepatoblastoma at multiple sites, including brain, left atrium of the heart and lung in a 6-year-old girl who was partially treated in the past at the age of 1.5 years; the patient had been event-free for four and a half years.

간모세포종은 15세 이하 연령에서 발생하는 간암 중 가장 흔하며 대부분 5세 미만에 발병된다. 진단시 폐전이가 동반되는 경우가 약 10%가 되나 심장이나 중추신경계에 전이된 보고는 상당히 드물며 예후도 좋지 못한 것으로 알려져 있다. 저자들은 약 4년 반 전 간모세포종으로 진단 받고 항암화학요법과 수술적 절제 후 추가 항암치료를 마치지 않고 추적관찰이 소실되었으나 그동안 무병 상태로 지내오다 폐와 좌측 심장, 중추신경계에 다발적으로 재발되어 다시 항암화학요법으로 치료를 시작한 후 호전을 보였으나 사정상 치료가 중단되어 있는 6세 여아에 대해 보고하는 바이다.

Keywords

References

  1. Bellani FF, Massimino M. Liver tumors in childhood : epidemiology and clinics. J Surg Oncol 1993:3:119-21
  2. Brown J, Perilongo G, Shafford E, Keeling J, Pritchard J, Brock P, et al. Pretreatment prognostic factors for children with hepatoblastoma-results from the International Society of Paediatric Oncology (SIOP) Study SIOPEL 1. Eur J Cancer 2000;36:1418-25 https://doi.org/10.1016/S0959-8049(00)00074-5
  3. Robertson PL, Muraszko KM, Axtell RA. Hepatoblastoma metastasis to brain : prolonged survival after multiple surgical resections of a solitary brain lesion. J Pediatr Hematol Oncol 1997;19:168-71 https://doi.org/10.1097/00043426-199703000-00016
  4. Feusner JH, Krailo MD, Haas JE, Campbell JR, Lloyd DA, Ablin AR. Treatment of pulmonary metastases of initial stage I hepatoblastoma in childhood. Cancer 1993;71:859-64 https://doi.org/10.1002/1097-0142(19930201)71:3<859::AID-CNCR2820710333>3.0.CO;2-T
  5. Begemann M, Trippett TM, Lis E, Antunes NL. Brain metastases in hepatoblastoma. Pediatr Neurol 2004;30:295-7 https://doi.org/10.1016/j.pediatrneurol.2003.10.014
  6. Endo EG, Walton DS, Albert DM. Neonatal hepatoblastoma metastatic to the choroid and iris. Arch Ophthalmol 1996; 114:757-61 https://doi.org/10.1001/archopht.1996.01100130749023
  7. Miyagi J, Kobayashi S, Kojo N, Watanabe M, Kuramoto S, Hirose F. Brain metastasis of hepatoblastoma : A case report and review of literature. No Shinkei Geta 1984;12:753-8
  8. Nagle SB, Deolekar MV, Dhamnaskar P. Hepatoblastoma with complete regeneration of liver and with metastasis to lungs and brain within six months after partial hepatectomy : A case report. Indian J Pathol Microbiol 1996;39:147-9
  9. Curless RG, Toledano SR, Ragheb J, Cleveland WW, Falcone S. Hematogenous brain metastasis in children. Pediatr Neurol 2002;26:219-21 https://doi.org/10.1016/S0887-8994(01)00363-0
  10. Wang JN, Chen JS, Chuang HY, Yang YJ, Chang KC, Wu JM. Invasion of the cardiovascular system in childhood malignant hepatic tumors. J Pediatr Hematol Oncol 2002;24: 436-9 https://doi.org/10.1097/00043426-200208000-00006
  11. Nishimura S, Sato T, Fujita N, Yamaoka H, Hiyama E, Yokoyama T, et al. High-dose chemotherapy in children with metastatic hepatoblastoma. Pediatr Int 2002;44:300-5 https://doi.org/10.1046/j.1442-200X.2002.01549.x