Brain metastasis of hepatoblastoma--a case report and review of literature
Miyagi, J.; Kobayashi, S.; Kojo, N.; Watanabe, M.; Kuramoto, S.; Hirose, F.
No Shinkei Geka. Neurological Surgery 12(6): 753-758
1984
ISSN/ISBN: 0301-2603 PMID: 6087182 Document Number: 223400
Hepatoblastoma is a rare abdominal tumor which affects infant, especially two or three year old boy. The authors experienced a rare case of cerebral metastasis of hepatoblastoma. The patient was a 1 and one thirds year old boy who was admitted because of left hemiparesis, somnolent consciousness, and abdominal tumor in September 21, 1982. At admission physical examination showed massive epigastric tumor with emaciated and dehydrated condition. Neurological evaluation indicated left spastic hemiparesis, somnolent consciousness and bilateral choked disc. Laboratory data were leukocytosis, marked thrombocytosis and slight abnormality of the liver function test. Alpha-fetoprotein level was 61 X 10(4) ng/ml and human chronic gonadotropin 20 IU/l. Chest X-P was suspected to be multiple metastatic lesions. Celiac angiogram showed a giant malignant tumor of the liver. Cranial CT scan revealed an intracerebral mass in the right frontal lobe which was visualized an enhanced high density area by contrast enhancement with a cystic component. The patient was diagnosed metastatic tumors of the brain and the lung with primary hepatoblastoma. En bloc tumor removal with right frontotemporal craniotomy was performed. Histological diagnosis of the removed tumor was a well differentiated type of the hepatoblastoma. Postoperative course was fine as for consciousness and hemiparesis. With recent development of chemotherapy and medical treatment for infantile malignancy, the prognosis of hepatoblastoma has been improved. This report is believed to be the first operative case for metastatic brain tumor of hepatoblastoma.