Cerebral Metastasis of Hepatoblastoma: A Review

Hepatoblastoma is rarely reported to metastasize to the brain. A comprehensive review of the literature was undertaken to characterize such patients and to examine the various therapies utilized to treat them. We identified 39 patients, including 1 previously unreported case from our institution. Although only 19 of these patients had much demographic information reported, it is notable that 24% (4/17) were older than 4 years at their original primary tumor diagnosis and 63% (7/11) had evidence of pulmonary metastases (at original diagnosis or recurrence) before the occurrence of brain metastasis. On the basis of the limited data published about this rare presentation and the known association of poor outcome with older age at diagnosis, we recommend additional neuroimaging in older hepatoblastoma patients when they present for evaluation of a pulmonary recurrence even when they are neurologically asymptomatic, with the aim of early identification and surgical resection of these lesions. The role of radiotherapy as an adjunct treatment for multiple cerebral lesions looks promising and needs to be explored further.