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4-yr-old finally diagnosed with rare liver cancer, under successful treatment at Thane hospital

Thane , Sep 20 (UNI) A 4 years old Jastik, a resident of Silvassa presented with features of poor weight gain, fever, jaundice. He was seen by multiple doctors, but no one was able to put their fingers
on a particular diagnosis.
He was later seen and thoroughly evaluated by Dr Lalit Verma Paediatric Gastroenterology and
Hepatologist in Wockhardt Hospital, Mira Road who found that there was significant abdominal distension with a mass suspecting it to be a tumour. By using clinical judgement, diagnostic tool like CT scan and blood markers, Dr Verma diagnosed this large liver mass as Hepatoblastoma. It is a rare tumor cancer of liver which can present even in 1st month of life.

An official release by Wockhardt today stated Later Dr Akansha (Pediatric oncologist) also came on board and jointly it was decided to start patient on chemotherapy (6 cycles). Once the cycles were
over a repeat CT scan was done which showed significant reduction in tumour size. At this point, Dr Krutarth (adult onco-surgeon) and Dr Kant (Pediatric onco-surgeon) were involved for the excision of
tumor mass.
This surgery demands a very challenging anesthesia management as malignancies are rare in this age group, and the surgery is extensive in an already compromised child. The child was
taken up as a high risk case under balanced general anesthesia along with epidural analgesia and invasive pressure monitoring. Intra operative, medicines which are safe for liver cases were given and
blood loss was replaced with blood and blood factors.
The child was shifted to the pediatric ICU where he was managed by Dr Rushil. Dr
Lalit Verma, Paediatric Gastroenterology and Hepatologist from Wockhardt Hospital, Mira Road said, Liver surgery is a challenging task. One has to plan the whole surgery mentally first looking at CT
scans in three dimensions as the anatomy of liver is very variable in all individuals.
Giving anesthesia involves not only keeping patient asleep for 6-8 hours but also monitor the blood pressure,
clotting factors, blood gases and such parameters very closely. It is like running an ICU inside the operation theatre. The surgery itself has to be very precise to minimize damage to the normal liver
which will be left behind after removing the large tumour. The tumour in Jastik’s case was initially involving almost 3/4th of his liver. After receiving 7 planned cycles of chemotherapy it had
shrunk to involve just over half of the liver.
Fortunately the tumour was removed in total with adequate margin of normal tissue.
The residual liver has shown normal biochemical function and we expect it to grow to an almost normal size.

He will receive three further chemotherapy cycles and we hope he has long term remission and cure. Presently Jastik is stable, with astoma bag. He is getting discharged with the same. Plan is to
bring him back for 3 chemo cycles.
UNI XR SY 2355
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