Hepatoblastoma

Abstract

Summary: Hepatoblastoma is an uncommon tumour of infancy and childhood. Hepatoblastoma in past had very poor outcomes, which presently has changed with introduction of chemotherapy and protocol based treatment described as SIOPEL. We would hereby like to submit the surgical video of this procedure. Case: A 13 month male child presented with abdominal distension and decreased oral intake, upon evaluation patient was found to have a heterogenous mass in segments 5,6,7 and 8(PRETEXT-II). Ultrasound guided fine needle aspiration suggested hepatoblastoma- fetal type. Child received 2 chemotherapy cycles of SIOPEL -3 protocol. Repeat Computed tomography revealed regression of tumour size. Patient underwent right hepatectomy. Intra and immediate post-operative period was uneventful. Patient had uneventful recovery and was discharged on post-operative day 6. Pre-operative AFP was 28,594 ng/ml. Post-op AFP- 147.9 ng/ml. At follow up period of 8 months patient is alive and having an event free survival. Conclusion: Multidisciplinary approach has steered to a great extent in improving overall and event free survival in patients with hepatoblastoma. Pre-operative chemotherapy makes surgical resection possible which is the definitive therapy for hepatoblastoma.