Hepatoblastoma in a Low Birth Weight Infant: Case Report and Review
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Hepatoblastoma in a Low Birth Weight Infant : A Case Report and Review of the Literature
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:
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Gurjeet Kaur, S S Mutum
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Hepatoblastoma in a Low Birth Weight Infant : A Case Report and Review of the Literature
Year: 2001
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Hepatoblastoma is the most common primary liver tumor in children, accounting for 25-40% of pediatric liver tumors and showing an incidence of 0.5-1.5 cases per million children worldwide. This case report details a one-year-old boy presenting with significant abdominal distension, weight loss, and other symptoms suggestive of a liver tumor. The patient had a history of premature birth at 28 weeks, low birth weight of 1.23 kg, and delayed developmental milestones. Diagnostic imaging revealed a large solid tumor in the left lobe of the liver, and serum alpha-fetoprotein (αFP) levels were significantly elevated.
Prematurity and Hepatoblastoma
Recent studies have highlighted a strong association between very low birth weight (under 1500 grams) or prematurity and the development of hepatoblastoma. In this case, the patient’s low birth weight and extreme prematurity corresponded with stage II of the tumor, indicating more advanced disease. This relationship suggests that genetically altered liver cells in premature infants, combined with various medical interventions, may contribute to tumor development. Characteristic symptoms of hepatoblastoma include a growing abdominal mass, weight loss, anemia, and elevated αFP levels, which are present in a majority of cases. Histopathological examination confirmed this patient’s tumor as the fetal type of hepatoblastoma, providing insight into its malignant nature and supporting existing literature on clinical presentation and risk factors.
Conclusion
Hepatoblastoma is a significant health concern in pediatric populations, particularly among those with many risk factors, including prematurity and low birth weight. Surgical intervention remains the primary treatment strategy; however, morbidity and mortality can be high, as evidenced by the patient’s postoperative complications leading to septicemia. As research continues to uncover associations between prenatal factors and hepatoblastoma, it is crucial to monitor at-risk infants for early detection and management of this aggressive neoplasm. Awareness of its clinical features and diagnostic criteria may aid in improving outcomes and survival rates in affected children.
FAQ section (important questions/answers):
What is hepatoblastoma and who does it primarily affect?
Hepatoblastoma is the most common primary liver tumor in children, accounting for 25-40% of pediatric liver tumors. It primarily affects young children, most commonly those under the age of three, with a median age of approximately 16 months.
What are the common symptoms of hepatoblastoma in children?
Common symptoms include progressive abdominal distension, weight loss, anorexia, vomiting, and failure to thrive. Many children present with anemia and elevated serum alpha-fetoprotein (αFP) levels at diagnosis.
What factors are associated with an increased risk of hepatoblastoma?
Factors include very low birth weight (under 1500g), prematurity, and possibly maternal exposures during pregnancy. Children born extremely premature are at higher risk for developing advanced hepatoblastoma.
What is the treatment approach for hepatoblastoma?
Surgical resection is the primary treatment. Chemotherapy may be used preoperatively to reduce tumor size, particularly in cases where resection is initially not possible. The overall three-year survival rate is between 62-70%.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Hepatoblastoma in a Low Birth Weight Infant: Case Report and Review”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Birth:
Birth is significant in the context of hepatoblastoma, especially for infants born prematurely or with very low birth weight (<1500g). Research indicates a strong association between such adverse birth conditions and the increased risk of developing hepatoblastoma, an aggressive liver tumor that primarily affects young children.
2) Disease:
Hepatoblastoma is classified as a childhood disease and represents the most common primary liver tumor in children. Understanding hepatoblastoma as a disease helps in identifying the clinical features, risk factors, and necessary treatment protocols essential for managing affected patients to improve outcomes and survival rates.
3) Chemotherapy:
Chemotherapy plays a critical role in the management of hepatoblastoma. It is often used preoperatively to reduce tumor size, making surgical resection more feasible. The response rate to cisplatin-containing regimes is high, which emphasizes the importance of chemotherapy in the overall treatment strategy and improving survival rates.
4) Cancer:
Hepatoblastoma is a type of cancer that arises in the liver and predominantly affects young children. Its classification as a cancer underscores its malignancy, aggressive nature, and the need for timely intervention through surgical resection and supportive therapies to mitigate the morbidity and mortality associated with cancer in pediatric patients.
5) Bile:
Bile is a digestive fluid produced by the liver, and its significance in hepatoblastoma is highlighted during pathological examinations. The tumor in this case exhibited bile-stained cut sections, suggesting the tumor's hepatic origin and involvement of liver functions. This sheds light on the tumor's nature and aids in diagnosing liver-related conditions.
6) Transformation (Transform, Transforming):
Transformation refers to the genetic alterations of liver cells that may predispose premature infants to hepatoblastoma. The idea is that certain developmental disturbances can lead to cancerous transformations, providing insight into the tumor's pathogenesis, which is crucial for understanding risk factors in infants with very low birth weight.
7) Measurement:
Measurement, particularly of serum alpha-fetoprotein (αFP), is essential in diagnosing hepatoblastoma. Elevated levels of αFP are found in a significant percentage of cases, and regular monitoring through the measurement can help in early detection, especially in high-risk populations like those with very low birth weight.
8) Developing:
Developing is relevant in the context of hepatoblastoma as it pertains to the identification of the tumor during the growth phase in children. The clinical presentation often includes abdominal masses and weight loss, highlighting the developing nature of this cancerous growth and the need for timely intervention.
9) Vomiting:
Vomiting can be a presenting symptom in children with hepatoblastoma due to increased abdominal pressure from the mass effect of the tumor. Recognizing vomiting as a clinical sign is important for timely diagnosis and intervention, as it often reflects gastrointestinal complications or distress from the tumor's presence.
10) Account:
Account in this context relates to the statistical tracking of hepatoblastoma cases. Understanding the incidence rates, particularly in vulnerable populations like those born preterm or with low birth weight, is essential for epidemiological analysis and can guide healthcare providers in monitoring and treating at-risk infants.
11) Surface:
Surface refers to the appearance of the tumor during pathological evaluation. Descriptions of the tumor’s cut surface as gray and bile-stained with areas of necrosis provide vital histological information that can aid in confirming the diagnosis of hepatoblastoma and understanding the tumor's biological behavior.
12) Study (Studying):
Study is imperative in the context of understanding hepatoblastoma. Research studies explore the associations between risk factors, genetic predispositions, and clinical outcomes, contributing to the overall knowledge of hepatoblastoma management, prognosis, and emerging therapies aimed at improving survival in affected pediatric patients.
13) Male (Mālē):
Male is relevant as it indicates gender-related epidemiological trends in hepatoblastoma, which exhibits a slight male predominance. Understanding these demographic factors is crucial for recognizing patterns in disease incidence, underlying genetic or environmental influences, and targeting appropriate screening and preventive measures in higher-risk groups.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Hepatoblastoma in a Low Birth Weight Infant: Case Report and Review’. Further sources in the context of Science might help you critically compare this page with similair documents:
Treatment, Intestinal obstruction, Ascites, Abdominal distension, Tumour, Microscopic examination, Premature birth, Case report, Low birth weight, Chronic liver disease, CT scan, Clinical presentation, Laboratory investigation, Birth weight, Surgical resection, Hepatitis B, Congenital Anomalies, Male predominance, Weight loss, Recent report, Gross pathological examination, Histopathological examination, Liver function test, Gestational age, Developmental milestone, Necrosis, Septicemia, Postoperative complication, Risk factor, Lymph Node, Failure to thrive, Alpha-fetoprotein, Survival rate, Clinical finding, Metastatic disease, Median age, Neonatal intensive care unit, Prognostic Factor, Complete excision, Chemotherapy treatment, Treatment of choice, High risk, Tumour volume, Abdominal ultrasound, Abdominal mass, Laparotomy, Thrombocytosis, Paralytic ileus, Tumour cells, Very Low Birth Weight, Median Age of Onset, Brief Review, Regional lymph nodes, Serum alpha-fetoprotein, Premature infant, Histological subtype, Chemotherapy response, Diagnostic feature, Human Chorionic Gonadotrophin, Histologic subtype.
Concepts being referred in other categories, contexts and sources.
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