Email this article Hepatoblastoma relapses with a normal level of alpha-fetoprotein: report of two cases
- Authors: Kachanov D.Y.1, Aliev T.Z.1, Moiseenko R.A.1, Roschin V.Y.1, Metelin A.V.2, Uskova N.G.1, Shamanskaya T.V.1, Filin A.V.2, Varfolomeeva S.R.1
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Affiliations:
- Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation
- B.V. Petrovsky Russian National Center of Surgery Russian Academy of Science
- Issue: Vol 18, No 4 (2019)
- Pages: 58-65
- Section: CLINICAL OBSERVATIONS
- Submitted: 30.12.2019
- Accepted: 30.12.2019
- Published: 30.12.2019
- URL: https://hemoncim.com/jour/article/view/285
- DOI: https://doi.org/10.24287/1726-1708-2019-18-4-58-65
- ID: 285
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Abstract
Hepatoblastoma (HB) is the most common malignant liver tumor in children. The level of alpha-fetoprotein (AFP) is used for monitoring the response to antitumor therapy and for diagnosing relapses. The occurrence of HB relapses with normal AFP levels in patients who had elevated levels of this tumor marker at disease onset is considered to be an uncommon situation. The aim of this study was to describe cases in which AFP-negative hepatoblastoma relapses developed. The study participants included two HB patients who were initially stratified into high-risk and standard-risk groups and who received treatment at the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology and the Petrovsky National Research Center of Surgery inMoscow. At the moment of relapse acknowledgement these patients had normal AFP levels, which was confirmed by serial measurements. Immunohistochemistry (IHC) tests were performed on paired samples of the tumor at disease onset and at disease relapse respectively to evaluate AFP expression. The presented clinical cases demonstrate that normal AFP levels, when accompanied by suspicious clinical symptoms, do not allow to exclude an HB relapse. The possibility of relapse with a normal AFP level reinforces the importance of following the current plan of screening tests, which includes not only an evaluation of AFP levels, but also other tests such as a chest X-ray and an abdominal ultrasound. Parents gave their consent to use information about the child in the article.
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About the authors
D. Yu. Kachanov
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation
Author for correspondence.
ORCID iD: 0000-0002-3704-8783
Correspondence: Denis Yu.Kachanov,MD, Department of clinical oncology, Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation.
Address: Russia 117997, Moscow, Samory Mashela st., 1
Russian FederationT. Z. Aliev
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation
ORCID iD: 0000-0003-1091-1521
Moscow Russian Federation
R. A. Moiseenko
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation
ORCID iD: 0000-0002-9654-084X
Moscow Russian Federation
V. Yu. Roschin
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation
ORCID iD: 0000-0002-9375-7517
Moscow Russian Federation
A. V. Metelin
B.V. Petrovsky Russian National Center of Surgery Russian Academy of Science
ORCID iD: 0000-0002-2399-6811
Moscow Russian Federation
N. G. Uskova
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation
ORCID iD: 0000-0001-9424-1646
Moscow Russian Federation
T. V. Shamanskaya
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation
ORCID iD: 0000-0002-3767-4477
Moscow Russian Federation
A. V. Filin
B.V. Petrovsky Russian National Center of Surgery Russian Academy of Science
ORCID iD: 0000-0003-4205-5627
Moscow Russian Federation
S. R. Varfolomeeva
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation
ORCID iD: 0000-0001-6131-1783
Moscow Russian Federation
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