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Abstract

Objective: To analyze the clinical and pathological features along with prognostic factors in a case of infantile hepatoblastoma accompanied by extramedullary hematopoiesis.

Methods: A comprehensive review was conducted, examining clinical presentations, imaging studies, histopathological morphology, and immunophenotypic profiles of the hepatoblastoma. The tumor's histological classification, postoperative adjuvant therapies, and prognostic determinants were also evaluated.

Results: The tumor in this case was characterized by solid clusters or nests of small to medium-sized immature hepatocytes. Endothelial cells within the stroma and the presence of extramedullary hematopoiesis were notably observed. Immunohistochemical analysis revealed partial positivity for AFP in tumor cells, along with nuclear, cytoplasmic, and membranous positivity for β-catenin. Expression of INI-1 was also positive, as were TdT and CD71 in the extramedullary hematopoietic regions. Morphological and immunohistochemical assessments classified the case as a pure epithelial hepatoblastoma with a mixed embryonic and fetal pattern. Following complete surgical excision, no evidence of distant metastasis was found. The patient was staged as Ib according to the COG Evans system and categorized within the low-risk clinical group.

Conclusion: A synergistic approach combining complete surgical resection with chemotherapy yields favorable long-term outcomes for hepatoblastoma patients in the low-risk stratum.

Keywords: Hepatoblastoma, Babies, Extramedullary hematopoiesis