Diagnosis and Treatment of a Preterm Infant With Inoperable Congenital Hepatoblastoma—A Case Report

Abstract

Reports of hepatoblastoma (HB) in preterm infants are quite rare. Herein, we report the clinical management of a preterm infant with inoperable congenital HB. A female fetus that had been diagnosed with a large liver tumor consistent with hemangioma was delivered by emergency cesarean section at 33 weeks of gestation because of fetal distress. Effective antitumor therapy could not be performed, resulting in rapid deterioration and death. The postmortem histopathologic analysis confirmed the tumor as a HB. This report demonstrates the difficulties inherent in both the image diagnosis of HB and in providing efficacious treatments for preterm infants with HB.

Case Report of Congenital Hepatoblastoma With the Onset at 30-Weeks' Gestation

“…Congenital liver occupation is a rare occurrence, with hemangioma being the most common, followed by hepatob lastoma and mesenchymal hamartoma (6). Hepatoblastoma is an embryo-derived liver tumor with early onset and is concentrated in children under 5 years old.…”

“…The development of fetuses' organ structures and functions is so different that the pharmacokinetics and pharmacodynamics for chemotherapy drugs are unstable. Additionally, the infants' tolerance to chemotherapy drugs and the forward impact on development make chemotherapy in newborns difficult (6). Four infants with hepatoblastoma who received chemotherapy in the neonatal period have been reported to have died; of these, two started chemotherapy on the basis of pulmonary hypertension and died of respiratory failure on their 23rd and 61st day, respectively (15,17), while two died of multiple tumor metastases during chemotherapy in their 6th and 20th month, respectively (18,19).…”