Rare 9 cm Liver Tumor Removed from 5-Month-Old Baby

Thiruvananthapuram: A multidisciplinary team at KIMSHEALTH Trivandrum achieved a medical breakthrough by successfully removing a 9 cm hepatoblastoma, a rare liver tumour, from a 5-month-old baby. The tumour, initially detected during an ultrasound at 33 weeks of pregnancy, was confirmed post-delivery via biopsy to be hepatoblastoma, a rare liver cancer primarily affecting children but exceptionally rare in neonates.

The medical team, led by Dr Naveen Jain (Senior Consultant, Department of Neonatology), Dr Azgar Abdul Rasheed (Associate Consultant, Medical Oncology), Dr Shabeerali T U (Senior Consultant, Hepatobiliary, Pancreatic & Liver Transplant Surgery), and Dr Shiraz Ahmad Rather (Clinical Chair, Multiorgan Transplant), adopted a multi-step approach involving chemotherapy to shrink the tumour before surgery.

"Administering chemotherapy to such a small infant is incredibly challenging," said Dr Shabeerali T U. "Our objective was to reduce the tumour size to make surgical intervention possible." The baby underwent chemotherapy successfully, shrinking the tumour enough for surgical removal.

Due to the tumour's complex involvement with critical blood vessels, concerns arose about the need for a liver transplant. The baby’s mother was evaluated as a potential donor but required lifestyle modifications, including diet and exercise, to meet the donor prerequisites. However, further chemotherapy enabled the surgical team to proceed without requiring a transplant.

The intricate twelve-hour surgery involved removing a significant portion of the liver, including the vena cava and the main blood vessel supplying the tumour. "Teamwork along with the confidence that the parents placed in the KIMSHEALTH medical team made this beautiful miracle happen," said Dr Naveen Jain.

Despite the complexities, including challenges with venous access and managing jaundice in the infant’s first months, the medical team successfully resected the tumour. "The NICU/PICU teams were very supportive, and the parents also took extra precautions to avoid exposing the baby to possible infections," added Dr Azgar Abdul Rasheed.

The baby recovered well post-surgery and was discharged a month later. The team credited the success to collaborative efforts across multiple specialties. Other key contributors included Dr Varghese Yeldho (Consultant, Hepatobiliary, Pancreatic and Liver Transplant Surgery), Dr Hashir A (Consultant, Anesthesiology), Dr Manoj K S (Senior Consultant, Imaging & Interventional Radiology), and Dr Manish Kumar Yadav (Senior Consultant, Neuro Interventional Radiology).