Bland embolization of a ruptured hepatoblastoma with massive intraperitoneal hemorrhage

Nariman Nezami, MD; Hans Michell, MD; Christos Georgiades, MD PHD; Elie Portnoy, MD

Radiology Case Reports (Nov 2020)

Bland embolization of a ruptured hepatoblastoma with massive intraperitoneal hemorrhage

Nariman Nezami, MD,
Hans Michell, MD,
Christos Georgiades, MD PHD,
Elie Portnoy, MD

Affiliations

Nariman Nezami, MD: Division of Vascular and Interventional Radiology, Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed Tower 7203, Baltimore, MD 21287, USA; Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
Hans Michell, MD: Section of Interventional Radiology, Department of Radiology, University of Vermont Medical Center, Burlington, VT, USA
Christos Georgiades, MD PHD: Division of Vascular and Interventional Radiology, Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed Tower 7203, Baltimore, MD 21287, USA
Elie Portnoy, MD: Division of Vascular and Interventional Radiology, Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed Tower 7203, Baltimore, MD 21287, USA; Corresponding author.

Journal volume & issue: Vol. 15, no. 11
pp. 2367 – 2370

Abstract

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Purpose: Hepatoblastoma is the most common primary neoplasm of the liver in the pediatric population, usually diagnosed during the first 5 years of life. Patients with large or peripheral hepatoblastomas are at risk for rupture and peritoneal hemorrhage. Image-guided, minimally invasive interventions are offered for controlling hemorrhage. Case presentation: We present a 2-year-old female with an 11.8 cm hepatoblastoma in the right hepatic lobe involving segment 4A, who developed hemodynamic instability on day 8 of induction chemotherapy. Imaging revealed intraperitoneal hemorrhage secondary to her ruptured hepatoblastoma. The patient was successfully treated by celiac artery angiogram and transarterial bland embolization. Conclusion: Transarterial bland embolization of large hepatoblastomas may control and even prevent intraperitoneal/intracapsular hemorrhage, and may also enhance the efficacy of systematic chemotherapy in the pediatric patients with advanced hepatoblastoma.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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