Related Experiment Video
Updated: Dec 7, 2025
Laparoscopic Anatomical Right Hemihepatectomy via the In Situ Anterior Approach
Published on: August 8, 2025
Bland embolization of a ruptured hepatoblastoma with massive intraperitoneal hemorrhage
Nariman Nezami1,2, Hans Michell3, Christos Georgiades1
1Division of Vascular and Interventional Radiology, Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed Tower 7203, Baltimore, MD 21287, USA.
Insights
Transarterial bland embolization effectively manages hemorrhage in pediatric hepatoblastoma. This interventional radiology technique can control bleeding from large liver tumors and potentially improve chemotherapy outcomes.
Area of Science:
- Pediatric oncology
- Interventional radiology
- Hepatobiliary diseases
Background:
- Hepatoblastoma is the most frequent primary liver cancer in children, typically diagnosed before age five.
- Large or peripherally located hepatoblastomas carry a significant risk of rupture and life-threatening peritoneal hemorrhage.
- Minimally invasive, image-guided interventions are crucial for managing hemorrhage in these pediatric patients.
Purpose:
Hepatoblastoma is the most common primary neoplasm of the liver in the pediatric population, usually diagnosed during the first 5 years of life. Patients with large or peripheral hepatoblastomas are at risk for rupture and peritoneal hemorrhage. Image-guided, minimally invasive interventions are offered for controlling hemorrhage.
Case Presentation:
We present a 2-year-old female with an 11.8 cm hepatoblastoma in the right hepatic lobe involving segment 4A, who developed hemodynamic instability on day 8 of induction chemotherapy. Imaging revealed intraperitoneal hemorrhage secondary to her ruptured hepatoblastoma. The patient was successfully treated by celiac artery angiogram and transarterial bland embolization.
Conclusion:
Transarterial bland embolization of large hepatoblastomas may control and even prevent intraperitoneal/intracapsular hemorrhage, and may also enhance the efficacy of systematic chemotherapy in the pediatric patients with advanced hepatoblastoma.
