A curable case with stage IV hepatoblastoma after brain relapse by multiple resections

Abstract

A 2-year-old boy was diagnosed as having stage IV hepatoblastoma in the right hepatic lobe, liver S2 tumor, and bilateral multiple lung metastases with high α-fetoprotein levels. After chemotherapy, the right hepatic lobe and metastatic lesions in S2 were resected. Some metastatic lesions in bilateral lungs were resected thereafter. After additional chemotherapy including autologous bone marrow transplantation, the remaining metastatic lesions in the right lung and left lower lobe were resected completely 41 months after onset. Although he developed brain metastasis at 44 months, this was resected completely followed by whole-brain irradiation. Since then, he has been in remission for 19 years. Complete resection is the most important prognostic factor and a principle of hepatoblastoma treatment. This case indicates that it is indispensable for achieving cure to resect lesions completely in multimodal treatments for metastatic hepatoblastoma.