A case of hepatoblastoma that was difficult to distinguish from hepatocellular carcinoma

Abstract

An abdominal mass was detected in an 11-year-old girl who presented with anemia and hyperlipidemia. A liver tumor was confirmed; hence, she was referred to our hospital. Enhanced computed tomography revealed that the tumor was located in both segment 4 and the right lobe (PRETEXT III); it stained deeper in the early phase and washed out in the equilibrium phase. The α-fetoprotein (AFP) level was 1,178 ng/mL. Owing to the patient’s age, AFP level, and imaging findings, hepatocellular carcinoma was strongly suspected. Therefore, one-stage extended right lobectomy was performed owing to biopsy-dissemination-related concerns, and hepatoblastoma was diagnosed pathologically. Tumor dissemination is a concern in biopsies for suspected hepatocellular carcinoma, but preoperative chemotherapy for hepatoblastoma is known to be useful. Therefore, although distinguishing primary liver tumors before biopsy is extremely difficult, the propriety of biopsy should be carefully evaluated according to each patient’s background characteristics.