Late Recurrence of Combined Hepatocellular Carcinoma and Hepatoblastoma in a Child: Case Report and Review of the Literature

Summary

We report on a case of late relapse of hepatocellular carcinoma in a child suffering from combined hepatoblastoma and hepatocellular carcinoma, stage IV. This is a rare event, as it has been accepted that a 5-year period free of any signs of disease in children suffering from malignant hepatic tumors is sufficient to classify such patients as survivors. In our patient, recurrence of the hepatocellular carcinoma component was diagnosed more than five years after the initial diagnosis. This case illustrates the need for more prolonged follow-ups for such children.

Résumé

Nous rapportons un cas de récidive tardive d'un carcinome hépato-cellulaire chez un enfant souffrant de l'association d'un hépatoblastome et d'un carcinome hépato-cellulaire de stade IV. Il est convenu de penser qu'un enfant ne présentant aucun signe de récidive pendant 5 ans est considéré comme guéri. Chez notre patient, la survenue de la récidive plus de 5 ans après le diagnostic initial illustre le besoin d'une surveillance prolongée.

Resumen

Presentamos un caso de recidiva tardía de carcinoma hepatocelular en un niño con hepatoblastoma y hepatocarcinoma grado IV combinados. Esta asociación es muy rara y se acepta que en niños con tumores hepáticos malignos un periodo de 5 años libre de enfermedad es suficiente para clasificarlos como sobrevivientes. En nuestro caso, la recidiva del carcinoma hepatocelular se diagnosticó más de 5 años tras el diagnóstico inicial. El caso ilustra la necesidad de un seguimiento muy prolongado en estos niños.

Zusammenfassung

Es wird ein Kind mit einem Spätrezidiv eines hepatozellulären Karzinoms vorgestellt, das wegen eines kombinierten Hepatoblastoms und hepatozellulären Karzinoms im Stadium IV behandelt worden war. Ein solches Spätrezidiv ist außerordentlich selten, da üblicherweise ein fünfjähriges, tumorfreies Intervall als vollständige Heilung von dem Tumor angesehen wird. Im vorliegenden Fall wurde das Rezidiv des hepatozellulären Karzinoms bzw. der hepatozellulären Komponente des primären Lebertumors mehr als fünf Jahre nach der Erstdiagnose diagnostiziert. Der Fall zeigt daher, dass es wichtig ist, auch über fünf Jahre hinaus diese Kinder sorgfältig zu überwachen.

Key words

Hepatoblastoma - Hepatocellular carcinoma - Late recurrence - Child

Mots-clés

Hépatoblastome - Carcinome hépato-cellulaire de l'enfant - Récidive tardive

Palabras clave

Hepatoblastoma - Hepatocarcinoma - Recidiva tardía - Niños

Schlüsselwörter

Hepatoblastom - Hepatozelluläres Karzinom - Spätrezidiv

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