Portal Vein Embolization Before Extended Hepatectomy in a Toddler With Mesenchymal Hamartoma

Area of Science:

• Pediatric Surgery
• Interventional Radiology
• Hepatobiliary Surgery

Background:

• Portal vein embolization (PVE) is a standard procedure to increase liver volume before major liver surgery.
• PVE aims to prevent postoperative liver failure by ensuring adequate liver function.
• PVE has not been documented in infants for liver tumor management.

Observation:

• A 14-month-old infant presented with a large, multifocal mesenchymal hamartoma involving the entire right lobe of the liver.
• The tumor necessitated an extended hepatectomy, requiring significant FLR hypertrophy.
• Percutaneous PVE was performed to induce hypertrophy of the left liver lobe (FLR).

Findings:

• The PVE procedure was technically successful in the infant.
• Significant hypertrophy of the FLR was achieved following PVE.
• The patient underwent successful resection of the liver tumor with an adequate FLR.
• No major postoperative complications related to liver insufficiency were observed.

Implications:

• This case demonstrates the feasibility and safety of PVE in a young child for liver tumor resection.
• PVE can be a valuable tool for managing large pediatric liver tumors requiring extensive resection.
• The findings support the expansion of PVE indications to include very young pediatric patients with significant liver lesions.