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Resection of hepatoblastoma with right atrial extension using cardiopulmonary bypass
T Murakami1, K Myojin, J Matano
1Division of Cardiovascular Surgery, National Sapporo Hospital, Japan.
Insights
A rare pediatric hepatoblastoma with intracardiac extension was successfully resected using cardiopulmonary bypass. This surgical approach facilitated complete removal of the tumor and a safe right hepatectomy.
Area of Science:
- Pediatric Oncology
- Surgical Oncology
- Cardiovascular Surgery
Background:
- Hepatoblastoma is a rare malignant liver tumor in children.
- Intracaval and intracardiac extension of hepatoblastoma is exceptionally rare.
- Surgical resection is the primary treatment for localized hepatoblastoma.
Observation:
- A 3-year-old boy presented with hepatoblastoma and a rare intracardiac extension into the right atrium via the inferior vena cava.
- The tumor necessitated a complex surgical approach due to its extensive intracardiac involvement.
Findings:
- A combined resection of the hepatoblastoma and its intracardiac extension was successfully performed.
- Cardiopulmonary bypass was crucial for enabling complete resection of the intracardiac tumor mass.
- Dissection and ligation of the right hepatic vein under cardiopulmonary bypass facilitated a safe and complete right hepatectomy.
Implications:
- This case demonstrates the feasibility and safety of using cardiopulmonary bypass for managing rare hepatoblastoma with intracardiac extension.
- The described surgical technique may serve as a valuable strategy for similar complex pediatric liver tumor cases.
- Successful management highlights the importance of multidisciplinary collaboration in pediatric surgical oncology.
Abstract:
A 3-year-old boy underwent a successful combined resection of a hepatoblastoma and its intracaval right atrial extension using a cardiopulmonary bypass. This type of extension is extremely rare in hepatoblastoma. The cardiopulmonary bypass enabled complete resection of the intracardiac mass of the hepatoblastoma. In addition, dissection and ligation of the right hepatic vein under cardiopulmonary bypass made the following right hepatectomy easy and safe.