Cắt gan trung tâm ở trẻ 6 tháng tuổi bị u nguyên bào đã điều trị hóa chất

TÓM TẮT Bệnh nhi 6 tháng tuổi được chẩn đoán u nguyên bào gan, ban đầu được xem là không thể cắt bỏ được vì khối u có kích thước lớn và lan tỏa. Bệnh nhân được điều trị 4 đợt hóa chất cisplatin với thời gian cách nhau 2 tuần. Kết quả chụp cắt lớp vi tính sau 4 đợt hóa trị cho thấy khối u đã thu nhỏ lại và có thể cắt bỏ. Khối u đã được cắt bỏ bằng phương pháp phẫu thuật cắt gan trung tâm. Bệnh nhân đã có thể ăn uống trở lại vào ngày thứ tư và xuất viện vào ngày thứ bảy sau mổ. Bác sĩ chuyên khoa nhi ung bướu đã theo dõi bệnh nhân bằng siêu âm gan, alpha - fetoprotein và tiếp tục điềutrị thêm 2 chu kỳ cisplatin. ABSTRACT CENTRAL HEPATECTOMY IN A 6 - MONTH - OLD CHILD WITH HEPATOBLASTOMA FOLLOWING CHEMOTHERAPY A hepatoblastoma in a 6 - month - old child was initially considered unresectable because of diffuse liver involvement. The patient received 4 courses of cisplatin with an interval time of 2 weeks. A computed tomography scan after 4 courses of chemotherapy showed shrinking of the tumor, which made it resectable, and the tumor was removed by central hepatectomy. The patient was able to eat a regular diet on the fourth day and was sent discharge on the seventh day, after the operation. The pediatric oncologist followed the patient with liver ultrasonography and alpha - fetoprotein and administered 2 more cycles of cisplatin. Keywords: Central Hepatectomy, Hepatoblastoma, children.

Liver Involvement in SARS-CoV-2 Vertically Infected Newborn: A Case Report

Neonatal SARS-CoV-2 infection can occur antenatally, peripartum, or postnatally. In the newborn, clinical manifestations may vary including fever and respiratory, gastrointestinal and neurological symptoms. Most commonly, they are subclinical. We herein present a case of vertical transmission of SARS-CoV-2 presenting with liver injury, characterized by an increase in serum transaminases.

Cystic angiomatosis of the bone, liver, and spleen

Introduction/Objective Cystic angiomatosis is a very rare entity characterized by multifocal cystic angiomatous lesions of the skeletal system, occasionally involving visceral organ systems. Clinical presentation and progression are extremely variable. Cases with liver involvement are even rarer, and have been described as invariably fatal. The pathogenesis of this disorder is poorly understood, and no treatments are currently available. Methods/Case Report A 24 year old man with history of polysubstance abuse and untreated hepatitis C presented with acute abdominal pain. Imaging revealed hepatosplenomegaly and multiple liver, spleen, and skeletal lesions. Differential diagnoses included metastatic disease, lymphoma, and infection. Apart from known untreated chronic hepatitis C, all infectious, autoimmune and hypercoagulability work-ups were negative. Biopsies of the liver and iliac bone lesions showed areas of benign-appearing vascular proliferation in a background of fibrosis. The vascular endothelial cells were positive for CD34 and CD31 but negative for D2-40. On follow-up approximately eight months later, the patient was asymptomatic. Results (if a Case Study enter NA) NA Conclusion Liver involvement by cystic angiomatosis is exceedingly rare and has been associated with increased mortality. This case provides an example of a patient with incidentally discovered cystic angiomatosis involving liver, spleen, and bone who remains asymptomatic at follow-up. Additional cases are required to understand the pathophysiology and disease course in this group of patients, and to investigate possible therapeutic targets.

Identification and validation of circulating miRNAs as potential new biomarkers for severe liver disease in patients with leptospirosis

Background Leptospirosis, a global zoonotic infectious disease, has various clinical manifestations ranging from mild self-limiting illness to life-threatening with multi-organ damage, including liver involvement. This study was aimed at identifying circulating microRNAs (miRNAs) as novel biomarkers for predicting severe liver involvement in patients with leptospirosis. Methods In a discovery set, 12 serum samples of patients with anicteric and icteric leptospirosis at initial clinical presentation were used for miRNA profiling by a NanoString nCounter miRNA assay. In a validated cohort, top candidate miRNAs were selected and further tested by qRT-PCR in serum samples of 81 and 16 individuals with anicteric and icteric leptospirosis, respectively. Results The discovery set identified 38 significantly differential expression miRNAs between the two groups. Among these, miR-601 and miR-630 were selected as the top two candidates significantly up-regulated expressed in the icteric group. The enriched KEGG pathway showed that these miRNAs were mainly involved in immune responses and inflammation. In the validated cohort, miR-601 and miR-630 levels were significantly higher in the icteric group compared with the anicteric group. Additionally, these two miRNAs displayed good predictors of subsequent acute liver failure with a high sensitivity of 100%. On regression analysis, elevated miR-601 and miR-630 expression were also predictive of multi-organ failures and poor overall survival. Conclusion Our data indicated that miRNA expression profiles were significantly differentiated between the icteric and anicteric groups. Serum miR-601 and miR-630 at presentation could potentially serve as promising biomarkers for predicting subsequent acute liver failure and overall survival in patients with leptospirosis.

Isolated Tuberculosis liver abscess in an immunocompetent patient.

Tuberculous (TB) infection remains one of the leading causes of death, especially in developing countries. TB liver involvement is a rare extrapulmonary manifestation of TB and is usually found as a secondary involvement to TB of the lung. Here we are presenting a case of Isolated TB liver abscess.