Hepatoblastoma with neonatal necrotizing enterocolitis: Two case reports

Area of Science:

• Pediatric Oncology
• Gastroenterology

Background:

• Neonatal necrotizing enterocolitis (NEC) is a severe gastrointestinal condition in premature infants.
• Hepatoblastoma (HB) is the most common primary malignant liver tumor in children.
• Premature birth and low birth weight are risk factors for both NEC and HB.

Observation:

• Two pediatric cases presented with hepatoblastoma (HB) after a history of neonatal necrotizing enterocolitis (NEC).
• Case 1: HB diagnosed at 5 months, initially noted during NEC surgery at 3 months. Showed metastasis and recurrence despite treatment.
• Case 2: HB diagnosed at 3 years, following NEC treatment in infancy. Achieved normal alpha-fetoprotein levels post-treatment.

Findings:

• Both patients survived and are in good health following surgical and chemotherapeutic interventions.
• The study underscores a potential association between NEC and HB, warranting further investigation.
• Alpha-fetoprotein (AFP) levels served as a key biomarker for monitoring HB recurrence.

Implications:

• Clinicians should maintain a high index of suspicion for hepatoblastoma in children with a history of necrotizing enterocolitis.
• Further research is needed to elucidate the underlying mechanisms connecting NEC and HB pathogenesis.
• Early recognition and management are vital for improving survival rates in pediatric hepatoblastoma.