Advertisement

Isolated caudate lobe (Spiegel lobe) resection for hepatoblastoma. Is it enough to achieve a sufficient resection margin? A case report

      Abstract

      Background

      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.

      Methods

      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.

      Results

      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.

      Conclusions

      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.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Pediatric Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Koga H.
        • Ishizaki Y.
        • Fujimura J.
        • et al.
        Complete resection of hepatoblastoma originating in the caudate lobe: case report and literature review.
        Pediatr Surg Int. 2009; 25: 1017-1020
        • Zimmermann A.
        • Perilongo G.
        • et al.
        Pediatric liver tumors.
        Springer, Berlin Heidelberg2011
        • Sarmiento J.M.
        • Que F.G.
        • Nagorney D.M.
        Surgical outcomes of isolated caudate lobe resection: a single series of 19 patients.
        Surgery. 2002; 132: 697-708
        • Yamamoto J.
        • Kosuge T.
        • Shimada K.
        • et al.
        Anterior transhepatic approach for isolated resection of the caudate lobe of the liver.
        World J Surg. 1999; 23: 97-101
        • Bartlett D.
        • Fong Y.
        • Blumgart L.H.
        Complete resection of the caudate lobe of the liver: technique and results.
        Br J Surg. 1996; 83: 1076-1081
        • Chaib E.
        • Ribeiro Jr., M.A.F.
        • de S Collet e Silva F.
        • et al.
        Surgical approach for hepatic caudate lobectomy: review of 401 cases.
        J Am Coll Surg. 2007; 204: 118-127
        • Hawkins W.G.
        • DeMatteo R.P.
        • Cohen M.S.
        • et al.
        Caudate hepatectomy for cancer: a single institution experience with 150 patients.
        J Am Coll Surg. 2005; 200: 345-352
        • Takayama T.
        • Makuuchi M.
        • Takayasu K.
        • et al.
        Resection after intraarterial chemotherapy of a hepatoblastoma originating in the caudate lobe.
        Surgery. 1990; 107: 231-235
        • Takayama T.
        • Makuuchi M.
        • Kosuge T.
        • et al.
        A hepatoblastoma originating in the caudate lobe radically resected with the inferior vena cava.
        Surgery. 1991; 109: 208-213
        • Okada A.
        • Yoneda A.
        • Azuma T.
        • et al.
        A resected case of hepatoblastoma originating in the caudate lobe.
        Eur J Pediatr Surg. 1992; 2: 49-51
        • Yanaga K.
        • Matsumata T.
        • Hayashi H.
        • et al.
        Isolated hepatic caudate lobectomy.
        Surgery. 1994; 115: 757-761
        • Wang Y.
        • Zhang L.Y.
        • Yuan L.
        • et al.
        Isolated caudate lobe resection for hepatic tumor: surgical approaches and perioperative outcomes.
        Am J Surg. 2010; 200: 346-351
        • Dicken B.J.
        • Bigam D.L.
        • Lees G.M.
        Association between surgical margins and long-term outcome in advanced hepatoblastoma.
        J Pediatr Surg. 2004; 39: 721-725
        • Malogolowkin M.H.
        • Katzenstein H.M.
        • Meyers R.
        • et al.
        Complete surgical resection is curative for children with hepatoblastoma with pure fetal histology: a report from the children's oncology group.
        J Clin Oncol. 2011; 29: 3301-3306