Dual Paraneoplastic Syndromes in a Case of Pediatric Hepatoblastoma: A Rare and Challenging Case
Journal Title: Pediatric Education and Research - Year 2017, Vol 5, Issue 2
Abstract
Hepatic malignant neoplasms comprise the third most common cause of intra-abdominal malignancies. Apart from the constellation of clinical findings associated with malignancies; liver malignancies have also been associated with perilous paraneoplastic syndromes. This report is about a 10 years old boy presenting with abdominal distension since 1 month with firm massive hepatosplenomegaly. Investigations revealed deranged liver enzymes with HBsAg positive status. CT abdomen was suggestive of heterogenous hepatic lesions. Serum alpha-fetoprotein level came as >90000 ng/ml. Liver biopsy revealed the diagnosis of Hepatoblastoma. Patient subsequently developed paraneoplastic symptoms in the form of hypertensive urgencies and resistant hypoglycaemic episodes manifesting as seizures requiring Nitroprusside drip ultimately and Glucose infusion Rate as high as 12mg/Kg/minute. On PRETEXT staging the tumour was classified as Stage 4 which is the non-resectable variety. The child was started on Cisplatin and Doxorubicin. However, he deteriorated, proceeding to liver failure with deranged liver function tests, raised PT/INR and active bleeding. The parents took a discharge against medical advicedue to financial constraints. As hepatoblastoma is extremely rare in this age group with the disease predominantly presenting as Paraneoplastic syndromes,Doctors should be ready for uncommon and rare possibilities.
Authors and Affiliations
Ankit Ranjan
Keywords
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- EP ID EP475324
- DOI 10.21088/per.2321.1644.5217.18
- Views 114
- Downloads 0
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