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Nieto Dominguez A, Eichinger SE, Matrova E, Almoghrabi A. Adult Hepatoblastoma and Concomitant Hepatitis B Infection. ACG Case Rep J 2024; 11:e01491. [PMID: 39238883 PMCID: PMC11377089 DOI: 10.14309/crj.0000000000001491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 07/29/2024] [Indexed: 09/07/2024] Open
Abstract
We report a case of hepatoblastoma in a 26-year-old man with a background of type 2 diabetes mellitus and untreated hepatitis B, initially presenting with hematemesis and a recent diagnosis of hepatocellular carcinoma on computed tomography scan from a different hospital and recent referral to hospice. On presentation to our hospital, given atypical presentation for hepatocellular carcinoma, histological examination was made, revealing hepatoblastoma. Treatment included chemotherapy and management of hepatitis B, although complicated by chemotherapy-induced cytopenias and tumor progression, ultimately losing the patient to follow-up after 2 years.
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Affiliation(s)
| | | | - Elza Matrova
- Department of Pathology, John H. Stroger Jr. Hospital of Cook County, Chicago, IL
| | - Anas Almoghrabi
- Department of Gastroenterology, John H. Stroger Jr. Hospital of Cook County, Chicago, IL
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Liu Y, El Jabbour T, Somma J, Nakanishi Y, Ligato S, Lee H, Fu ZY. Blastomas of the digestive system in adults: A review. World J Gastrointest Surg 2024; 16:1030-1042. [PMID: 38690053 PMCID: PMC11056657 DOI: 10.4240/wjgs.v16.i4.1030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/03/2024] [Accepted: 03/25/2024] [Indexed: 04/22/2024] Open
Abstract
Blastomas, characterized by a mixture of mesenchymal, epithelial, and undifferentiated blastematous components, are rare malignant neoplasms originating from precursor blast cells. This review focuses on digestive system blastomas in adult patients, including gastroblastoma, hepatoblastoma, and pancreatoblastoma. Gastroblastoma is a biphasic, epitheliomesenchymal tumor, with only sixteen cases reported to date. In addition to the characteristic histology, metastasis-associated lung adenocarcinoma transcript 1 - glioma-associated oncogene homolog 1 gene fusion is typical, although recently novel ewing sarcoma breakpoint region 1 - c-terminal binding protein 1 and patched 1 - glioma-associated oncogene homolog 2 fusions have been described. Hepatoblastoma is exceptionally rare in adults and can show a variety of histologic patterns which may cause diagnostic difficulty. Pancreatoblastoma, primarily a pediatric tumor, displays acinar differentiation and squamoid nests with other lines of differentiation also present, especially neuroendocrine. Diagnostic approaches for these blastomas include a combination of imaging modalities, histopathological examination, and molecular profiling. The treatment generally involves surgical resection, which may be supplemented by chemotherapy or radiotherapy in some cases. Prognoses vary with gastroblastoma generally showing favorable outcomes post-surgery whereas hepatoblastoma and pancreatoblastoma often have poorer outcomes, particularly in the setting of metastases. This review highlights the complexity of diagnosing and managing these rare adult blastomas as well as the need for ongoing research to better understand their pathogenesis and improve treatment strategies.
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Affiliation(s)
- Yu Liu
- Department of Pathology, LSU Health Sciences Center School of Medicine, New Orleans, LA 70112, United States
| | - Tony El Jabbour
- Department of Pathology, Hartford HealthCare, Hartford, CT 06102, United States
| | - Jonathan Somma
- Department of Pathology, LSU Health Sciences Center School of Medicine, New Orleans, LA 70112, United States
| | - Yukihiro Nakanishi
- Department of Pathology, Moffitt Cancer Center, Tampa, FL 33612, United States
| | - Saverio Ligato
- Department of Pathology, Hartford HealthCare, Hartford, CT 06102, United States
| | - Hwajeong Lee
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY 12208, United States
| | - Zhi-Yan Fu
- Department of Pathology, LSU Health Sciences Center School of Medicine, New Orleans, LA 70112, United States
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Millan-Alanis JM, González Torres LA, Ferrant-Noo A, Alcala-Gonzalez JI. Metastatic Hepatoblastoma in Adolescence: A Clinical Case Report and Literature Review. Cureus 2024; 16:e58460. [PMID: 38765389 PMCID: PMC11100445 DOI: 10.7759/cureus.58460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Hepatoblastoma is the most common hepatic neoplasm in children. However, its incidence is infrequent beyond age five. We present the case of a 15-year-old female diagnosed with metastatic hepatoblastoma during hospitalization for liver function deterioration. The patient presented with abdominal distension, jaundice, and other symptoms indicative of advanced disease. Imaging and biopsy confirmed stage IV epithelial hepatoblastoma with pulmonary metastases. This case underscores the importance of considering hepatoblastoma in older pediatric patients or young adults presenting with hepatic masses despite lacking traditional risk factors for liver malignancies.
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Affiliation(s)
- Juan Manuel Millan-Alanis
- Department of Internal Medicine, Hospital Universitario Dr. Jose Eleuterio Gonzalez, Universidad Autonoma De Nuevo Leon, Monterrey, MEX
| | - Luis A González Torres
- Department of Internal Medicine, Hospital Universitario Dr. Jose Eleuterio Gonzalez, Universidad Autonoma De Nuevo Leon, Monterrey, MEX
| | - Alfonso Ferrant-Noo
- Department of Internal Medicine, Hospital Universitario Dr. Jose Eleuterio Gonzalez, Universidad Autonoma De Nuevo Leon, Monterrey, MEX
| | - Joel Isai Alcala-Gonzalez
- Department of Internal Medicine, Hospital Universitario Dr. Jose Eleuterio Gonzalez, Universidad Autonoma De Nuevo Leon, Monterrey, MEX
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Rayya F, Almansour M. Mesohepatectomy for recurrent hepatoblastoma in a nine year old boy. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2020.101503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Venus A, Mehta SS, Natarajan S. A Rare Nonhepatocytic Primary Liver Neoplasm with an Unusual Presentation: Ossifying Malignant Mixed Epithelial and Stromal Tumor. Indian J Med Paediatr Oncol 2018. [DOI: 10.4103/ijmpo.ijmpo_55_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractWe present a case of a rare liver neoplasm – Ossifyimg malignant mixed epithelial and stromal tumor. This entity has well-delineated morphological and immunohistochemical features, and so can be easily diagnosed, even with core biopsy tissue. Our patient was a middle-aged male, which is unheard of in the literature of this disease. He had a bad recurrence of the disease after surgical removal of the tumor, unlike the previously reported cases with the same diagnosis, where the patients lived for almost a decade after surgery without recurrence. This neoplasticdisease can thus take a destructive course, and a change in treatment methods such as neoadjuvant or adjuvant chemotherapy should be thought of, to make it more beneficial and effective.
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Affiliation(s)
- Albina Venus
- Department of Pathology, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India
| | - Sangita Sharma Mehta
- Department of Pathology, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India
| | - Sumathi Natarajan
- Department of Radiology, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India
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Celotti A, D'Amico G, Ceresoli M, Tomasoni M, Raimondo S, Baggi P, Baiocchi GL. Hepatoblastoma of the adult: A systematic review of the literature. Surg Oncol 2016; 25:339-347. [PMID: 27566042 DOI: 10.1016/j.suronc.2016.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 06/06/2016] [Accepted: 07/18/2016] [Indexed: 11/30/2022]
Abstract
Hepatoblastoma is the most common malignant liver tumor in children. On the other hand in the adult HB is very rare and characterized by unfavorable prognosis. A review of the entire literature was performed: 58 articles and 63 cases of HB were found. The patient's data were collected and analyzed. No correlation with hepatitis virus was found and AFP was elevated in most cases. Usually HB forms a large single mass in the liver and presents aggressive behavior, with local invasiveness and metastatic spread. The current median survival time is 5 months, with a 1-year survival rate near 30%. Surgical resection is the only curative treatment. However major liver resections or extensive demolitions of the adjacent organs are necessary. There are no standardized protocols in the multimodal approach to this tumor.
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Affiliation(s)
- Andrea Celotti
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
| | - Giuseppe D'Amico
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy
| | - Marco Ceresoli
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy
| | - Matteo Tomasoni
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy
| | - Stefano Raimondo
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy
| | - Paolo Baggi
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy
| | - Gian Luca Baiocchi
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy
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Celotti A, Baiocchi GL, Ceresoli M, Bartoli M, Ulinici S, Portolani N. Hepatoblastoma of the adult with pericardial metastasis: A case report. Int J Surg Case Rep 2016; 20:80-83. [PMID: 26826931 PMCID: PMC4818299 DOI: 10.1016/j.ijscr.2016.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 01/13/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hepatoblastoma is the most frequent liver tumor in children, but very rare in the adult and associated with an unfavorable prognosis. The diagnosis is always postoperative or post mortem and biopsy is not useful. Surgery is the only accepted treatment. CASE PRESENTATION Our patient underwent surgery in the suspect of liver metastasis from a previous gastric cancer. Surgery consisted in left lobectomy with partial diaphragm resection and partial pericardiectomy for a pericardial lesion, found after the opening of the thorax. The diaphragm defect was corrected with a biological mesh. RESULTS The histopathological examination indicated hepatoblastoma of the adult with pericardial metastases. The patient was asymptomatic and without recurrence after 21 months of follow up. CONCLUSION The hepatoblastoma of the adult is related to a poor prognosis with median survival time less than 5 months. Surgery is the only curative treatment, but in many cases tumor resection requires complex operations. Vascular and thoracic expertise could be useful in the management of hepatoblastoma.
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Affiliation(s)
- Andrea Celotti
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy.
| | - Gian Luca Baiocchi
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy
| | - Marco Ceresoli
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy
| | - Michele Bartoli
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy
| | - Silvia Ulinici
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy
| | - Nazario Portolani
- Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, 25123 Brescia, Italy
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Huang G, Shu L, Xu J. Heart Failure and Main Pulmonary Artery Obstruction Caused by Right Ventricular Metastatic Adult Hepatoblastoma: A Case Report. Medicine (Baltimore) 2015; 94:e1535. [PMID: 26376403 PMCID: PMC4635817 DOI: 10.1097/md.0000000000001535] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We report a case of a 18-year-old boy who presented with dyspnea and right upper quadrant abdominal dull pain. According to urgent echocardiography, a dense sessile mass occupied the right ventricule. Tumor resection was performed, followed by further adjuvant therapy. The specimen was histopathologically investigated and eventually diagnosed as metastatic adult hepatoblastoma. We discuss its clinical features and treatment in the light of the current knowledge. It is important for us to be aware that adjuvant chemotherapy might be an effective alternative in the treatment of hepatoblastoma combined with ventricle invasion. Early cardiac surgery may be advised in patients with cardiac function impairment.
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Affiliation(s)
- Gongcheng Huang
- From the Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University, ZhengZhou, Henan, P. R. China
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