Segment 6 monosegment-preserving hepatectomy for hepatoblastoma: individualizing treatment beyond the resectability criteria

摘要

Monosegment-preserving hepatic resections are very rarely considered in patients with locally advanced tumors given the high risk of liver failure from an inadequate liver remnant (1,2). Where this is considered, the associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) technique, a two-staged procedure in order to induce remnant volume hypertrophy, have been reported (1,2). However, ALPPS has been known to have a high complication rate, hence even more infrequently, this complicated technique has been contemplated for pediatric patients (2). In the case we present, we identified an infant with a locally advanced hepatoblastoma with a unique anatomic presentation, that certainly precludes the possibility of ALPPS, but which otherwise provided the team with the opportunity to perform a single-staged monosegment-preserving hepatectomy with curative intent, in lieu of the alternative of liver transplantation (LT).