This document provides information about hepatoblastoma, a rare type of liver cancer that primarily affects young children under 3 years old. Some key points: - Hepatoblastoma is the most common malignant liver tumor in children. It has a rising incidence rate of 0.5-1.5 cases per million. - Risk factors include prematurity and very low birth weight (<1,500 g). The average age of diagnosis is 12-21 months, with 4% being congenital cases. - Signs may include abdominal swelling without other symptoms, or more severe signs in large tumors like digestive issues or pain. - Diagnosis involves blood tests showing elevated alpha-fetoprotein levels over 10,

1. HEPATOBLASTOMA
Lic. Rosa Gasco Garcia

2. El hepatoblastoma es el tumor hepático maligno más frecuente en la infancia. Afecta sobre todo a niños
menores de 3 años. Se trata de un tumor infrecuente, cuya incidencia parece aumentar en los últimos
años. Puede aparecer de forma aislada o integrarse en el contexto de un síndrome de predisposición.
DEFINICIÓN

3. EPIDEMIOLOGÍA
El hepatoblastoma (HB) supone el
79% de los tumores hepáticos
malignos pediátricos, pero solo el
2% de todos los tumores malignos
infantiles
01
La etiología se desconoce,
aunque se han descrito
factores de riesgo como la
prematuridad y un muy bajo
peso al nacer (< 1.500 g)
02
03
El promedio de edad en el
momento del diagnóstico varía
de 12 a 21 meses. El 4%
corresponde a formas
congénitas. La incidencia es
más elevada en los niños
portadores de anomalías
congénitas
04
La proporción en función del
sexo (varones/mujeres) es de
alrededor de 1,5 y la incidencia
se estima en 0,5-1,5 casos por
millón

4. Clasificación

6. SIGNOS CLINICOS
El signo revelador suele ser un
aumento de volumen del abdomen sin
otros signos asociados, salvo en los
tumores muy voluminosos (trastornos
del tránsito o dolor)
El diagnóstico puede
sospecharse en caso de
pubertad precoz con
secreción anormal de -HCG
(subunidad de la
gonadotropina coriónica
humana)
Puede manifestarse por una
ruptura tumoral o una
hemorragia intraabdominal
causante de un síndrome
abdominal agudo
La fiebre, el dolor, la ictericia
y la alteración del estado
general
Se han descrito varios
casos de asociación con
una osteoporosis
generalizada con fracturas.

7. DIAGNÓSTICO

8. Venus has a beautiful
name and is the second
planet from the Sun
VENUS
Concentración sérica de alfa-fetoproteína
La AFP es un marcador
muy sensible, pero
inespecífico de los tumores
hepáticos. Su
concentración debe
interpretarse en función de
la edad, porque existe una
secreción fisiológica en
recién nacidos
En todos los casos de
secreción no tumoral,
la concentración no es
tan elevada como en
los hepatoblastomas,
donde la
concentración sérica
media es mayor de 1,1
× 104ng/ml en el 90%
de los casos

9. Se puede observar una gran masa en el hígado
y áreas de hemorragia interna dentro del
tumor.
Ecografía abdominal
tomografía computarizada
(TC)
multifásica o la resonancia magnética nuclear (RMN).

10. BIOPSIA
HEPATICA
Aunque el diagnóstico de HB es muy
probable basándose en la asociación
de un tumor hepático con el aumento
de la AFP por encima de 104ng/ml,
la biopsia es necesaria para precisar
la biología del tumor y avanzar en
las posibilidades terapéuticas, al
permitir una mejor estratificación de
los pacientes antes de cualquier
tratamiento. La biopsia con aguja de
tipo Tru-Cut bajo anestesia general y
guiada por ecografía es el método
de elección. Debe realizarse a través
del hígado sano, dando prioridad al
método coaxial para evitar el riesgo
de diseminación tumoral
intraperitoneal
El diagnóstico histológico
de una muestra de tumor
es esencial, aunque
algunos investigadores
creen que la biopsia
puede no ser necesaria
en niños muy pequeños
(6 meses a 3 años) y así
evitar la probabilidad de
crecimiento o
diseminación del tumor

11. CLASIFICACION PRETEX
En Europa el Childhood Liver
Tumor Study Group de la Sociedad
Universal de Oncología Pediátrica
(SIOPEL) ha desarrollado la
evaluación preoperatoria del
sistema de estadificación de la
expansión tumoral (PRETEXT), que
parece ser un instrumento preciado
para la estratificación del peligro.

12. TRATAMIENTO
QUIMIOTERAPIA
CIRUGIA

13. PROTOCOLO HB
ALTO RIESGO
SIOPEL 4

14. SIOPEL 4
leucopenia, trombocitopenia y
anemia dosis-dependientes,
ototoxicidad (más grave en niños),
anorexia, náuseas, vómitos, diarrea y
fiebre.

15. BLOQUE B Y C

16. CIRUGIA
MANEJO QUIRURGICO DEL HB

17. CUIDADOS DE ENFERMERIA

18. CUIDADOS DE ENFERMERIA

22. “This is a quote, words full of
wisdom that someone
important said and can
make the reader get
inspired.”
—SOMEONE FAMOUS

23. CLINICAL TRIAL
PRECLINICA
L
Mars is a actually a
very cold place
Human safety
PHASE 1
Venus is the
second planet from
the Sun
Expanded safety
PHASE 2
Mercury is the
smallest planet
Efficacy & safety
PHASE 3
Lab studies

24. TRIAL TIMELINE
1
Mercury is the closest
planet to the Sun and the
smallest one in the Solar
System
RESEARCH
2
Despite being red, Mars is
actually a cold place. It's
full of iron oxide dust
EXPERIMENTAL
3
Venus has a beautiful
name and is the second
planet from the Sun. It’s
terribly hot
RESULTS
4
Neptune is the farthest
planet from the Sun. It's
also the fourth-largest
object
CONCLUSIONS

25. 80%
PHASE 1
20%
MERCUR
Y
It’s the closest
planet to the
Sun
80%
MARS
Mars is a very
cold place
Success rate
Despite being red, Mars is
actually a cold place. It's
full of iron oxide dust
RESULTS
Young healthy people
20 - 80 Participants

26. TREND
PHASE 1
Despite being red, Mars is a
cold place. It's full of iron oxide
dust
PHASE 2
Neptune is the farthest planet
from the Sun. It's really cold
there
PHASE 3
Saturn is a gas giant. It’s
composed of hydrogen and
helium
Follow the link in the graph to modify its data and then paste
the new one here. For more info, click here

27. RESULTS
OUTCOME
TREATME
NT
123 42 397
GROUP 1 256 - 423
GROUP 2 90 89 190
GROUP 3 - 245 99
EXPERIMENT A
OUTCOME
TREATME
NT
- 36 93
GROUP 1 315 70 150
GROUP 2 777 - -
GROUP 3 375 - 36
EXPERIMENT B

28. A PICTURE IS
WORTH A
THOUSAND
WORDS

29. RESULTS ANALYSIS
JUPITER
Jupiter is the biggest planet in
the entire Solar System
15%
Venus has a
very beautiful
name
30%
Mercury is the
smallest planet
55%
Mars is a very
cold place
SATURN
Saturn is a gas giant and is
composed of hydrogen and
helium
EARTH
Earth is the third planet from
the Sun and the only one with
life

30. SUCCESS RATE
Neptune is the farthest
planet from the Sun. It's
really cold there
NEPTUNE
10%
Despite being red, Mars
is actually a cold place.
It's full of iron oxide
dust
MARS
30%
Jupiter is the biggest
planet in the Solar
System. It’s a gas giant
JUPITER
60%

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and the smallest”
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farthest-known
planet from the Sun”
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