Research Article| Volume 47, ISSUE 10, e29-e32, October 2012

Perinatal hemorrhage complicating neonatal hepatoblastoma: case report


      Hepatoblastoma is the most common malignant liver tumor of infancy and presents most frequently at a median age of 18 months. Presentation in the neonatal period is rare, and there are very few reports of an antenatal diagnosis of hepatoblastoma. We recently encountered a neonate who presented with hemoperitoneum after rupture of a congenital hepatoblastoma during vaginal delivery. After successful right hepatectomy and adjuvant cis-platinum–based chemotherapy, the child is doing well. We draw attention to rarity of this condition and difficulty in definitively establishing a diagnosis both in the antenatal and neonatal periods and discuss the management dilemmas in congenital presentations of hepatoblastoma.

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        • Exelby P.R.
        • Filler R.M.
        • Grosfeld J.L.
        Liver tumors in children in the particular reference to hepatoblastoma and hepatocellular carcinoma: American Academy of Pediatrics Surgical Section Survey-1974.
        J Pediatr Surg. 1975; 10: 329-337
        • Bulterys M.
        • Goodman M.T.
        • Smith M.A.
        • et al.
        Hepatic tumors.
        in: Reis L.A.G. Smith M.A. Gurney J.G. Cancer Incidence and Survival Among Children and Adolescents: United States SEER Program, 1975–1995. National Cancer Institute SEER Program. NIH Pub. No. 99–4649, Bethesda MD1999: 91-97
        • Huang L.C.
        • Ho M.
        • Chang W.C.
        • et al.
        Prenatal diagnosis of fetal hepatoblastoma with a good neonatal outcome: case report and narrative literature review.
        Pediatr Hematol Oncol. 2011; 288: 150-154
        • Ammann R.A.
        • Plaschkes J.
        • Leibundgut K.
        Congenital hepatoblastoma: a distinct entity.
        Med Pediatr Oncol. 1999; 32: 466-468
        • Ergin H.
        • Yildirim B.
        • Dagdeviren E.
        • et al.
        A prenatally detected case of congenital hepatoblastoma.
        Pathol. Onocol. Res. 2008; 14: 97-100
        • Shih J.C.
        • Tsao P.N.
        • Huang S.F.
        • et al.
        Antenatal diagnosis of congenital hepatoblastoma in utero.
        Ultrasound Obstet Gynecol. 2000; 16: 94-97
        • Catanzarite V.
        • Hilfiker M.
        • Daneshmand S.
        • et al.
        Prenatal diagnosis of fetal hepatoblastoma: case report and review of the literature.
        Ultrasound Med. 2008; 27: 1095-1098
        • Koch A.
        • Waha A.
        • Hartmann W.
        • et al.
        Elevated expression of wnt antagonists is a common event in hepatoblastomas.
        Clin Cancer Res. 2005; 11: 4295-4304
        • Lopez-Terrada D.
        • Gunaratne P.H.
        • Adesina A.M.
        • et al.
        Histologic subtypes of hepatoblastoma are characterized by differential canonical Wnt and Notch pathway activation in DLK+ precursors.
        Hum Pathol. Jun 2009; 40: 783-794
        • Al-Hussein H.A.
        • Graham E.M.
        • Tekes A.
        • et al.
        Pre- and postnatal imaging of a congenital hepatoblastoma.
        Fetal Diagn Ther. 2011; 30: 157-159
        • Kazzi N.J.
        • Chang C.H.
        • Roberts E.C.
        • et al.
        Fetal hepatoblastoma presenting as nonimmune hydrops.
        Am J Perinatol. 1989; 6: 278-280
        • Doss B.J.
        • Vicari J.
        • Jacques S.M.
        • et al.
        Placental involvement in congenital hepatoblastoma.
        Pediatr Dev Pathol. 1998; 1: 538-542
        • Savall H.M.
        • Payarols P.J.
        • Villate H.V.
        • et al.
        Hepatoblastoma: a report of a case diagnosed in utero [in Spanish].
        An Esp Pediatr. 1993; 39: 265-267
        • Aviram R.
        • Cohen I.J.
        • Kornreich L.
        • et al.
        Prenatal imaging of fetal hepatoblastoma.
        J Matern Fetal Neonatal Med. 2005; 17: 157-159
        • Sallam A.
        • Paes B.
        • Bourgeois J.
        Neonatal hepatoblastoma: two cases posing a diagnostic dilemma, with a review of the literature.
        Am J Perinatol. 2005; 22: 413-419
        • Hartley A.L.
        • Birch J.M.
        • Kelsey A.M.
        • et al.
        Epidemiological and familial aspects of hepatoblastoma.
        Med Pediatr Oncol. 1990; 18: 103-109
        • Breysem L.
        • Bosmans H.
        • Dymakowski S.
        • et al.
        The value of fast MR imaging as an adjunct to ultrasound in prenatal diagnosis.
        Eur Radiol. 2003; 13: 1538-1548
        • Pasquier J.C.
        • Morelle M.
        • Bagouet S.
        • et al.
        Effects of residential distance to hospitals with neonatal surgery care on prenatal management of outcome of pregnancies with severe fetal malformations.
        Ultrasound Obstet Gynecol. 2007; 29: 271-275