A Case of Repeated Laparoscopic Partial Hepatectomy for Liver Metastasis of Ewing’s Sarcoma Family of Tumors

Abstract

We report the case of an 8-year-old boy with Ewing’s sarcoma family of tumors of the right chest wall after treatment. He was initially diagnosed at 4 years of age. The patient achieved remission by multidisciplinary therapy. One year and nine months later, computed tomography showed a liver metastasis of 23 mm diameter located in segment 6 and a lung metastasis. After neoadjuvant chemotherapy, laparoscopic partial hepatectomy was performed for the liver metastasis at 7 years of age. Subsequently, he underwent lung resection and postoperative chemotherapy. Eleven months later, CT revealed a liver metastasis of 16 mm diameter in segment 2. We performed a second laparoscopic partial hepatectomy when he was 8 years and 8 months of age. Mild adhesion was observed at the previous surgical site of the liver, but there were no adhesions in the left lateral segment, which enabled us to operate safely. No transfusion was required during either of the perioperative periods of the laparoscopic surgeries, and there were no postoperative complications. Laparoscopic hepatectomy has become commonly used in adults, but there are only a few reports on its use in pediatric cases. Laparoscopic surgery is minimally invasive and causes less adhesion. This case demonstrates that laparoscopic surgery is useful for pediatric patients with a high risk of recurrence.