Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk, Poland.
J Pediatr Surg. 2013 May;48(5):E25-7. doi: 10.1016/j.jpedsurg.2013.02.101.
Hepatoblastoma arising from and limited to the caudate lobe is an extremely rare clinical entity. The object of this case report is to present a case of isolated caudate lobe resection due to hepatoblastoma originating in the caudate lobe.
The patient was an 18-month-old male who was admitted with a huge tumor located in the left hepatic lobe. The histological diagnosis was fetal type of hepatoblastoma. The patient received 4 cycles of preoperative and 2 cycles of postoperative chemotherapy.
During surgical exploration, a well-defined, exophytic tumor originating in the caudate lobe was found. Isolated caudate lobe (Spiegel lobe) resection was performed. The intra- and postoperative course was uneventful. Surgical margins were negative for tumor. The patient remains alive with no signs of recurrence 15 months after surgery.
Isolated caudate lobe resection is one of the most challenging procedures in liver surgery. Despite the technical difficulties and high complications risk, isolated caudate lobectomy can be performed successfully in children. It needs to be noted that in the reported case, preoperative chemotherapy shrunk the tumor and largely facilitated its resection.
起源于并局限于尾状叶的肝母细胞瘤是一种极为罕见的临床实体。本病例报告的目的是介绍一例因起源于尾状叶的肝母细胞瘤而进行单纯尾状叶切除术的病例。
患者为 18 个月大的男性，因左肝巨大肿瘤入院。组织学诊断为胎儿型肝母细胞瘤。患者接受了 4 个周期的术前化疗和 2 个周期的术后化疗。
术中探查发现起源于尾状叶的边界清楚的外生性肿瘤。行单纯尾状叶（Spiegel 叶）切除术。手术过程和术后均顺利。手术切缘无肿瘤。术后 15 个月，患者无复发迹象，仍存活。
单纯尾状叶切除术是肝脏手术中最具挑战性的手术之一。尽管存在技术难度和高并发症风险，但在儿童中可以成功进行单纯尾状叶切除术。需要注意的是，在本报告病例中，术前化疗使肿瘤缩小，在很大程度上促进了肿瘤的切除。
