Key result
A two-stage surgical approach comprising hepatic tumor resection followed by cardiothoracic thrombectomy and thromboendarterectomy resulted in the patient remaining disease-free at four years.
Why the study?
Does a two-stage surgical approach improve outcomes in a pediatric patient with hepatic embryonal undifferentiated sarcoma with cardiothoracic involvement?
Case Report (n=1)
Does a two-stage surgical approach improve outcomes in a pediatric patient with hepatic embryonal undifferentiated sarcoma with cardiothoracic involvement?
A two-stage surgical approach involving hepatic resection and subsequent cardiothoracic thrombectomy/thromboendarterectomy can result in long-term disease-free survival in pediatric hepatic embryonal undifferentiated sarcoma with cardiothoracic extension.
May support two-stage resection with CPB in select pediatric hepatic sarcomas; hypothesis-generating, needs prospective validation.
Thorough study is required to decide the appropriate management of hepatic tumors in children. We present a case report of a hepatic embryonal undifferentiated sarcoma with unfavorable prognosis in a nine-year-old girl. After undergoing a detailed cancer characteristics and extension study, a two-stage surgery approach was decided. The hepatic tumor resection was the first procedure to be performed. One week later, under cardiopulmonary bypass, deep hypothermia, and circulatory arrest, thrombectomy of the inferior vena cava and right atrium was accomplished, plus thromboendarterectomy of the right pulmonary artery. During a four-year follow-up, the patient continues to be disease-free.
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Domínguez-Massa et al. (2018) conducted a case report in Hepatic embryonal undifferentiated sarcoma with cardiothoracic involvement (n=1). Two-stage surgery approach (hepatic tumor resection followed by thrombectomy and thromboendarterectomy) was evaluated on Disease-free status. A two-stage surgical approach comprising hepatic tumor resection followed by cardiothoracic thrombectomy and thromboendarterectomy resulted in the patient remaining disease-free at four years.
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