Hepatoblastoma in childhood, long term survival achieved: 2 case reports and literature review

• Hepatoblastoma is the most common primary liver tumor for children under 5 years of age, with an incidence of 5.2 per million.
• Diagnosis depends on imaging studies, AFP levels and percutaneous biopsy.
• Treatment modality is usually surgical with neoadjuvant chemotherapy.
• Remission and long term survival can be achieved after complete anatomical resection and appropriate neoadjuvant chemotherapy.
• Hepatoblastoma cases should be referred to specialized centers for management.

IntroductionHepatoblastoma is the most common primary liver tumor for children under 5 years of age. It usually presents as an abdominal mass, symptomatic only when large enough to cause mass effect on nearby organs. Symptoms such as early satiety, anorexia, abdominal pain or weight loss are the most common. Diagnosis depends on imaging studies, AFP levels and percutaneous biopsy. Treatment modality is usually surgical with neoadjuvant chemotherapy.CasesIn this article, we present 2 cases of hepatoblastoma treated 15 years ago by neoadjuvant chemotherapy and surgery, and are presenting for long term follow-up with complete disease remission.DiscussionComplete resection and remission can be achieved as demonstrated below by our 2 cases of hepatoblastoma, especially when performing a true anatomical hepatectomy, along with a neoadjuvant chemotherapy regimen. Although one of the cases did not respond to chemotherapy very well a complete resection was achieved and therefore a disease free survival of 15 years.ConclusionHepatoblastoma are rare tumors of the pediatric age group. Management depends highly on combined surgical and pediatric oncological knowledge. A complete disease remission can be achieved when both modalities are treatment are optimal. Therefore, hepatoblastoma cases should be referred to specialized centers for management.