Tsuchida Y, Bastos J C, Honna T, Kamii Y, Hori T, Mochida Y
Department of Surgery, National Children's Hospital, Tokyo, Japan.
J Pediatr Surg. 1990 Dec;25(12):1253-5. doi: 10.1016/0022-3468(90)90522-b.
A 30-month-old boy was investigated because of a huge abdominal mass in the right upper abdomen. A computed tomography scan and celiac angiography showed that the tumor involved bilateral lobes of the liver. At first, for this disseminated and "unresectable" tumor we did liver biopsy and hepatic arterial catheterization. Through this catheter we started chemotherapy using THP-Adriamycin and cis-platinum. After three courses of chemotherapy, a second-look operation was performed and trisegmentectomy was done to remove the main tumor and metastases, including the left lobe and the right anterior segment. The trisegmentectomy was performed with success, and the boy's serum alpha-fetoprotein (AFP) remains normal 37 months after the start of treatment, indicating a probable permanent cure. Such cases have rarely been reported in the literature. Our experience in treating this patient would seem to encourage aggressive management of advanced hepatoblastoma in other patients.
一名30个月大的男孩因右上腹巨大腹部肿块接受检查。计算机断层扫描和腹腔血管造影显示肿瘤累及肝脏的双侧叶。起初，对于这种弥漫性且“无法切除”的肿瘤，我们进行了肝活检和肝动脉插管。通过该导管，我们开始使用吡柔比星和顺铂进行化疗。经过三个疗程的化疗后，进行了二次探查手术，并实施了三段切除术以切除主要肿瘤和转移灶，包括左叶和右前叶。三段切除术成功完成，治疗开始37个月后，该男孩的血清甲胎蛋白（AFP）仍保持正常，表明可能已实现永久性治愈。此类病例在文献中鲜有报道。我们治疗该患者的经验似乎鼓励对其他晚期肝母细胞瘤患者采取积极的治疗措施。
