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Zhu LR, Zheng W, Gao Q, Chen T, Pan ZB, Cui W, Cai M, Fang H. Epigenetics and genetics of hepatoblastoma: Linkage and treatment. Front Genet 2022; 13:1070971. [DOI: 10.3389/fgene.2022.1070971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 11/14/2022] [Indexed: 12/02/2022] Open
Abstract
Hepatoblastoma is a malignant embryonal tumor with multiple differentiation modes and is the clearest liver malignancy in children. However, little is known about genetic and epigenetic events in Hepatoblastoma. Increased research has recently demonstrated, unique genetic and epigenetic events in Hepatoblastoma, providing insights into its origin and precise treatment. Some genetic disorders and congenital factors are associated with the risk of Hepatoblastoma development, such as the Beckwith-Wiedemann syndrome, Familial Adenomatous polyposis, and Hemihypertrophy. Epigenetic modifications such as DNA modifications, histone modifications, and non-coding RNA regulation are also essential in the development of Hepatoblastoma. Herein, we reviewed genetic and epigenetic events in Hepatoblastoma, focusing on the relationship between these events and cancer susceptibility, tumor growth, and prognosis. By deciphering the genetic and epigenetic associations in Hepatoblastoma, tumor pathogenesis can be clarified, and guide the development of new anti-cancer drugs and prevention strategies.
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Park KW, Seo CJ, Yun DY, Kim MK, Kim BS, Han YS, Oh HK, Lee CH. A case of hepatoblastoma misdiagnosed as combined hepatocellular carcinoma and cholangiocarcinoma in an adult. Clin Mol Hepatol 2015; 21:300-8. [PMID: 26523273 PMCID: PMC4612292 DOI: 10.3350/cmh.2015.21.3.300] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 02/14/2014] [Accepted: 02/21/2014] [Indexed: 01/20/2023] Open
Abstract
Hepatoblastoma usually occurs in children under the age of 2 years, with very few cases reported in adults. We experienced a case of adult hepatoblastoma in a 36-year-old female with chronic hepatitis B. She had experienced sudden onset abdominal pain. Her serum alpha-fetoprotein level was markedly elevated, and abdominal CT showed a 9-cm mass with internal hemorrhage in the right hepatic lobe with hemoperitoneum, so an emergency hepatic central bisectionectomy was performed. The initial histologic examination revealed that the mass mimicked combined hepatocellular carcinoma and cholangiocarcinoma with spindle-cell metaplasia of the cholangiocarcinoma element. Follow-up abdominal CT performed 3 months later showed a 5.5-cm metastatic mass in the left subphrenic area. Laparoscopic splenectomy with mass excision was performed, and hepatoblastoma was confirmed histologically. A histologic re-examination of previously obtained surgical specimens also confirmed the presence of hepatoblastoma. Metastatic hepatoblastoma was found at multiple sites of the abdomen during follow-up, and so chemotherapy with cisplatin, 5-fluorouracil (5-FU), and vincristine was applied, followed by carboplatin and doxorubicin. Despite surgery and postoperative chemotherapy, she died 12 months after symptom onset.
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Affiliation(s)
- Keun Woo Park
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Chang Jin Seo
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Dae Young Yun
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Min Keun Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Byung Seok Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Young Seok Han
- Department of Surgery, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Hoon Kyu Oh
- Department of Pathology, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Chang Hyeong Lee
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
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Rodrigues TC, Fidalgo F, da Costa CML, Ferreira EN, da Cunha IW, Carraro DM, Krepischi ACV, Rosenberg C. Upregulated genes at 2q24 gains as candidate oncogenes in hepatoblastomas. Future Oncol 2015; 10:2449-57. [PMID: 25525853 DOI: 10.2217/fon.14.149] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
AIM Cytogenetic data of hepatoblastomas, a rare embryonal tumor of the liver, mostly consist of descriptions of whole-chromosome aneuploidies and large chromosome alterations. High-resolution cytogenetics may provide clues to hepatoblastoma tumorigenesis and indicate markers with clinical significance. PATIENTS & METHODS We used array-CGH (180K) to screen for genomic imbalances in nine hepatoblastomas. Additionally, we investigated the expression pattern of selected genes exhibiting copy number changes. RESULTS Analysis showed mainly whole-chromosome or chromosome-arm aneuploidies, but some focal aberrations were also mapped. Expression analysis of 48 genes mapped at one 10 Mb amplification at 2q24 revealed upregulation of DAPL1, ERMN, GALNT5, SCN1A and SCN3A in the set of tumors compared with differentiated livers. CONCLUSION These genes appear as candidates for hepatoblastoma tumorigenesis.
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Affiliation(s)
- Tatiane Cristina Rodrigues
- Department of Genetics & Evolutionary Biology, Institute of Biosciences, University of São Paulo, São Paulo, Brazil
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Paraneoplastic recurrent hypoglycaemic seizures: an initial presentation of hepatoblastoma in an adolescent male-a rare entity. Case Rep Pediatr 2014; 2014:104543. [PMID: 25525545 PMCID: PMC4267168 DOI: 10.1155/2014/104543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 11/04/2014] [Indexed: 11/18/2022] Open
Abstract
Hepatoblastoma (HB) is a rare malignant tumour of the liver and usually occurs in the first three years of life. Hepatoblastoma in adolescents and young adults is extremely rare; nevertheless the prognosis is much worse than in childhood, because these kinds of tumours are usually diagnosed late. Characteristic imaging and histopathological and AFP levels help in the diagnosis of hepatoblastoma. Paraneoplastic features of hepatoblastoma are not uncommon at presentation and include erythrocytosis, thrombocytosis, hypocalcaemia, isosexual precocious puberty, and rarely hypoglycaemia. Even though hypoglycaemia is commonly seen in hepatocellular carcinoma, its association with hepatoblastoma is very rare. We present a case of 15-year-old male patient presenting with complaints of recurrent hypoglycaemic seizures ultimately leading to diagnosis of hepatoblastoma. Managed successfully with neoadjuvant chemotherapy, surgery and adjuvant chemotherapy with adriamycin and cisplatin based regimens. An extensive review of literature in the PubMed and MEDLINE did not reveal much data on paraneoplastic recurrent hypoglycaemic seizures as an initial presentation of hepatoblastomas in adolescents and young adults.
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Adult hepatoblastoma: A case report and literature review. Int J Surg Case Rep 2012; 4:204-7. [PMID: 23279808 DOI: 10.1016/j.ijscr.2012.10.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 10/05/2012] [Accepted: 10/27/2012] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Adult hepatoblastoma is a rare malignant liver neoplasm. Surgery is the only cure, but recurrence is common even after complete resection. No therapeutic strategy has been established. PRESENTATION OF CASE A 22-year-old man presented with a rapidly expanding right hypochondrial mass. Pain preceded the appearance of the mass. No definitive diagnosis was established in the referring hospital. In addition, two attempts of embolization failed to reach the tumor due to its large size and vascular displacement. Clinical examination revealed a 26cm×23cm mass occupying the right hypochondrium and epigastrium as far as the right iliac fossa, compressing the stomach, spleen, kidneys and liver. The preoperative diagnosis was gastrointestinal stromal tumor because it appeared to originate from the stomach. During surgery, we found a mass arising from the liver, adhering to the omentum, stomach, and left hemidiaphragm, and infiltrating the pericardium. The tumor was completely resected off the inferior vena cava and pericardium. The histopathological diagnosis was a 30cm×30cm hepatoblastoma weighing 4kg. The postoperative treatment course went smoothly until day 10, when the patient developed complications like bilateral atrial thrombi and left ventricular hypokinesia and expired on day 16. DISCUSSION Due to the rarity of hepatoblastoma in adults and non-specific initial symptoms, hepatoblastoma is often overlooked as a diagnosis. Early detection may lead to improved prognosis and survival. CONCLUSION We report here the first case of adult hepatoblastoma in the Middle East and the largest such tumor ever reported in literature.
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Altered microRNA Expression Patterns in Hepatoblastoma Patients. Transl Oncol 2011; 2:157-63. [PMID: 19701500 DOI: 10.1593/tlo.09124] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Revised: 03/16/2009] [Accepted: 03/16/2009] [Indexed: 12/23/2022] Open
Abstract
Liver cancers in children are rare representing only 1.1% of malignancies, with an annual incidence rate of 1.5 cases per million. Hepatoblastoma and hepatocellular carcinomas are the most common malignancies of the liver occurring in young people aged 15 years or younger. Molecular basis of both tumors are still unclear, and common markers (i.e., CTNNB1, APC, IGF-2) are not always useful in the characterization of sporadic forms; in this respect, microRNA recently associated with carcinogenesis could play a pivotal role in their onset. CTNNB1 and APC were analyzed by sequencing, and IGF-2 promoter methylation status was assessed by methylation-specific polymerase chain reaction. MicroRNA expression was assayed by microarray and quantitative reverse transcription-polymerase chain reaction in hepatoblastoma samples. Although few genomic alterations were detected in ours samples, an altered expression of somemicroRNA in hepatoblastoma was observed. Unsupervised clustering shows that microRNA profile can distinguish tumor from nontumor tissues. Further analyses of microRNA contents in hepatoblastoma compared with hepatocellular carcinoma highlighted four upregulated microRNA (miR-214, miR-199a, miR-150 [P < .01], and miR-125a [P < .05]) and one downregulated microRNA (miR-148a [P < .01]). In conclusion, although our samples were poorly informative from a genetic point of view, they showed a peculiar microRNA expression pattern compared with nontumor tissues and hepatocellular carcinoma. MicroRNA could represent valid markers for the classification of pediatric liver tumors.
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Mixed hepatoblastoma in a young male adult: a case report and literature review. Case Rep Med 2010; 2010:919457. [PMID: 21113306 PMCID: PMC2990241 DOI: 10.1155/2010/919457] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 10/27/2010] [Indexed: 11/18/2022] Open
Abstract
Hepatoblastoma (HB) is a rare malignant tumour of the liver and usually occurs in the first three years of life. Most of these tumours arise in the embryo; hence it seems to be unusual that hepatoblastoma occurs in adults and is an exceptional cause of primary malignant liver tumour in adult patients. The diagnosis is often overlooked, and patients might be diagnosed at late stages of the disease at risk of increased mortality. In this paper we report a case of a 30-year-old man with mixed hepatoblastoma and abdominal pain, hepatomegaly and fever. The patient under went noninvasive diagnostic methods: duplex scanning, Computed Tomography (CT), and Magnetic Resonance imaging (MRI). In our experience, despite the important role of histological sample provided by biopsy in defining the diagnosis, very important was the role of MRI, more than ultrasonography and enhanced CT. The MRI detects tumor features as size, margins, and ratio with neighboring organs in order to get the best surgical approach.
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Cytogenetic and array comparative genomic hybridization analysis of a series of hepatoblastomas. ACTA ACUST UNITED AC 2009; 194:82-7. [PMID: 19781440 DOI: 10.1016/j.cancergencyto.2009.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Revised: 04/29/2009] [Accepted: 06/01/2009] [Indexed: 12/15/2022]
Abstract
Hepatoblastoma is the most common primary hepatic tumor in children, and only a limited number of detailed karyotypic analyses have been reported to date. In the present study, cytogenetic abnormalities were identified in nine cases of hepatoblastoma from a single institution. Among characteristic chromosomal changes detected were simple numerical aberrations, structural alterations of chromosomes 1, 2, and 8, and the recurrent unbalanced rearrangements der(4)t(1;4)(q25.2;q35.1) and der(6)t(1;6)(q21;q26). Array comparative genomic hybridization was applied in four of the cases. The combined cytogenetic, molecular cytogenetic, and histopathologic analyses are presented here, together with clinical data. The results substantially confirm previous findings of aberrations involving chromosomal loci on 1q, 2 or 2q, 4q, 6q, 8 or 8q, and 20 as significant in the development and clinical course of this disease.
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Zheng MH, Zhang L, Gu DN, Shi HQ, Zeng QQ, Chen YP. Hepatoblastoma in adult: review of the literature. J Clin Med Res 2009; 1:13-6. [PMID: 22505959 PMCID: PMC3318863 DOI: 10.4021/jocmr2009.01.1222] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2009] [Indexed: 11/23/2022] Open
Abstract
This study is to review and retrieve data on adult hepatoblastoma (HB) from English literatures in order to gain a better understanding of this disease. We performed Medline, PubMed (from January 1966 to February 2008), and library searches (National Science and Technology Library, Beijing, China, and Wenzhou Medical College Library, from January 1980 to February 2008) using the key words hepatoblastoma in adult, hepatic tumor, hepatoblastoma and adult. Previously reported HB cases were collected and published reviews were also examined. Fifteen cases that met the search criteria were selected. Review of the cases revealed a slight female preponderance. The patients' age ranged from 17 to 82, with median age of 70 for male and 27 for female. The survival time ranged from two weeks to 38 months, and the median survival time was 6 months. In the articles reviewed, HB presented with non-specific initial symptoms, and the diagnosis was not identified until the tumor biopsy after operation or autopsy. Completely surgical resection is still the major treatment for patients with HB and is considered as the only chance of a better prognosis. Due to the rareness of HB in adults, the choice of treatment should be radical resection if possible, and combined with chemotherapy as adopted in children. HB in the adult is extremely rare and the pre-operative diagnosis is often overlooked. The prognosis is so poor that the awareness of the condition in the differential diagnosis in liver tumors could be beneficial.
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Affiliation(s)
- Ming Hua Zheng
- Department of Infection and Liver Diseases, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
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Chin SF, Hamid NAA, Latiff AA, Zakaria Z, Mazlan M, Yusof YAM, Karim AA, Ibahim J, Hamid Z, Ngah WZW. Reduction of DNA damage in older healthy adults by Tri E Tocotrienol supplementation. Nutrition 2007; 24:1-10. [PMID: 17884341 DOI: 10.1016/j.nut.2007.08.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Revised: 06/25/2007] [Accepted: 08/06/2007] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The free radical theory of aging (FRTA) suggests that free radicals are the leading cause of deteriorating physiologic function during senescence. Free radicals attack cellular structures or molecules such as DNA resulting in various modifications to the DNA structures. Accumulation of unrepaired DNA contributes to a variety of disorders associated with the aging process. METHODS A randomized, double-blinded placebo-controlled study was undertaken to evaluate the effect of Tri E Tocotrienol on DNA damage. Sixty four subjects 37-78 y old completed the study. A daily dose of 160 mg of Tri E Tocotrienol was given for 6 months. Blood samples were analyzed for DNA damage using comet assay, frequency of sister chromatid exchange (SCE), and chromosome 4 aberrations. RESULTS Results showed a significant reduction in DNA damage as measured by comet assay after 3 mo (P < 0.01) and remained low at 6 mo (P < 0.01). The frequency of SCE was also reduced after 6 mo of supplementation (P < 0.05), albeit more markedly in the >50 y-old group (P < 0.01) whereas urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels were significantly reduced (P < 0.05). A strong positive correlation was observed between SCE with age, whereas weak positive correlations were observed in DNA damage and 8-OHdG, which were reduced with supplementation. However, no translocation or a stable insertion was observed in chromosome 4. CONCLUSION Tri E Tocotrienol supplementation may be beneficial by reducing DNA damage as indicated by a reduction in DNA damage, SCE frequency, and urinary 8-OHdG.
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Affiliation(s)
- Siok-Fong Chin
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Al-Rahawan MM, Chute DJ, Sol-Church K, Gripp KW, Stabley DL, McDaniel NL, Wilson WG, Waldron PE. Hepatoblastoma and heart transplantation in a patient with cardio-facio-cutaneous syndrome. Am J Med Genet A 2007; 143A:1481-8. [PMID: 17567882 DOI: 10.1002/ajmg.a.31819] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cardio-facio-cutaneous syndrome (CFC) and Costello syndrome (CS) are disorders with an overlapping spectrum of congenital anomalies. Mutations in the RAS-MAPK pathway have recently been reported in both of these syndromes, with HRAS mutations characteristic for CS and BRAF and MEK1/2 mutations for CFC. We report on a 3-year-old boy who underwent a cardiac transplant at age 8 months for hypertrophic cardiomyopathy; he was subsequently suspected to have CS. At age 35 months he presented with an intra-cardiac mass that was diagnosed as metastatic hepatoblastoma. Although hepatoblastoma is not known to have an increased frequency in immunocompromised patients, questions were raised as whether the post-transplant immuno-suppressive therapy played a role in tumor development. The patient died shortly thereafter and his post-mortem DNA analysis revealed a MEK1 mutation (Y130C) previously reported in CFC. While CS is associated with increased cancer risk, only a single case of leukemia has been reported in a patient with CFC, making this the first case of a solid tumor reported in a patient with CFC.
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Affiliation(s)
- Mohamad M Al-Rahawan
- Department of Pediatrics,University of Virginia Health System, Charlottesville, Virginia.
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Ross DW, Wichman C. 3-month-old boy with a liver mass: conclusion. Air Med J 2006; 25:138-42. [PMID: 16818162 DOI: 10.1016/j.amj.2006.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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Ke HY, Chen JH, Jen YM, Yu JC, Hsieh CB, Chen CJ, Liu YC, Chen TW, Chan DC. Ruptured hepatoblastoma with massive internal bleeding in an adult. World J Gastroenterol 2005; 11:6235-7. [PMID: 16273660 PMCID: PMC4436650 DOI: 10.3748/wjg.v11.i39.6235] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatoblastoma is the most common primary hepatic tumor of children. However, only a very few cases have been reported in adults. Most studies support treatment with chemotherapy followed by surgical resection. We present the first reported case of adult hepatoblastoma in Taiwan. A 52-year-old female suffered from sudden onset of abdominal pain and general weakness for days. Internal bleeding with hemorrhagic shock was suspected and two massive lesions in both lobes of the liver with hemoperitoneum were noted from imaging studies. Surgical resection of the larger left lobe tumor and radio-frequency ablation of the right smaller one were performed. The histopathology diagnosis was of a hepatoblastoma.
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Affiliation(s)
- Hung-Yen Ke
- Division of General Surgery, Tri-Service General Hospital, 325, Sec. 2, Chen-Kung Road, Neihu 114, Taipei, Taiwan, China.
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Okamura N, Nakadate H, Ishida K, Nakahara S, Isobe Y, Ohbu M, Okayasu I. Telangiectatic focal nodular hyperplasia of the liver in the perinatal period: case report. Pediatr Dev Pathol 2005; 8:581-6. [PMID: 16211451 DOI: 10.1007/s10024-005-0037-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2005] [Accepted: 06/06/2005] [Indexed: 01/06/2023]
Abstract
We report a case of congenital telangiectatic focal nodular hyperplasia, a rare variant form of the disease. The patient was a 2-month-old boy whose parents noticed abdominal distention about 2 weeks after birth, and ultrasonogram revealed a large mass in the liver. He underwent right lobectomy, and gross findings showed an ill-defined mass without any central scar. Histologic findings demonstrated proliferating hepatocytes without atypia arranged in cords of 1- or 2-cell thickness with marked sinusoidal dilatation and extramedullary hematopoiesis. In addition, a significantly increased Ki-67 labeling index in the tumor compared with non-tumor liver cells, and cytogenetic analysis of 23 G-banded metaphase preparations revealed 3 abnormal karyotypes, suggesting hyperplastic or neoplastic features. To the best of our knowledge, the present case is only the third documented case of congenital telangiectatic focal nodular hyperplasia.
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Affiliation(s)
- Nobuyoshi Okamura
- Cyto-histopathology, Graduate School of Medical Science, Kitasato University, 1-15-1 Kitasato Sagamihara, Kanagawa 228-8555, Japan
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