Hanson Derek, Walter Andrew W, Dunn Stephen, Rittenhouse David W, Griffin Gregory
Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
J Pediatr Hematol Oncol. 2011 Aug;33(6):e258-60. doi: 10.1097/MPH.0b013e318212ecb3.
A 6-week-old boy presented with fever, pallor, and hepatomegaly. Ultrasound showed a huge midline abdominal mass. β-human chorionic gonadotropin was markedly elevated, suggesting a diagnosis of infantile choriocarcinoma of the liver. A biopsy confirmed the diagnosis. The patient received 6 cycles of bleomycin, cisplatin, and etoposide with significant decrease in tumor size. However, the tumor remained unresectable. A donor liver became available, and the infant underwent successful liver transplantation. He received 2 posttransplant cycles of moderate dose of methotrexate. This case shows the use of liver transplantation in cases of infantile choriocarcinoma of the liver where the tumor remains unresectable despite chemotherapy.
一名6周大的男婴出现发热、面色苍白和肝肿大。超声检查显示腹部中线有一个巨大肿块。β-人绒毛膜促性腺激素显著升高,提示诊断为肝母细胞瘤。活检确诊了该诊断。患者接受了6个周期的博来霉素、顺铂和依托泊苷治疗,肿瘤大小显著减小。然而,肿瘤仍无法切除。有了供体肝脏,该婴儿成功接受了肝移植。他在移植后接受了2个周期的中等剂量甲氨蝶呤治疗。该病例显示了在肝母细胞瘤患者中,尽管进行了化疗但肿瘤仍无法切除时,肝移植的应用。