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Volume 9
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10.3390/children9030376
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Case Report

Combined Use of Three-Dimensional Construction and Indocyanine Green-Fluorescent Imaging for Resection of Multiple Lung Metastases in Hepatoblastoma

by
Shugo Komatsu
*,
Keita Terui
,
Mitsuyuki Nakata
,
Ryohei Shibata
,
Satoru Oita
,
Yunosuke Kawaguchi
,
Hiroko Yoshizawa
,
Tomoya Hirokawa
,
Erika Nakatani
and
Tomoro Hishiki
Department of Pediatric Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan
*
Author to whom correspondence should be addressed.
Children 2022, 9(3), 376; https://doi.org/10.3390/children9030376
Submission received: 24 January 2022 / Revised: 28 February 2022 / Accepted: 6 March 2022 / Published: 8 March 2022
(This article belongs to the Special Issue Surgical Management for Children with Primary Liver Tumors)
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Abstract

It is essential to accurately and safely resect all tumors during surgery for multiple lung metastases. Here, we report a case of hepatoblastoma (HB) with multiple pulmonary nodules that ultimately underwent complete resection using combined three-dimensional image reconstruction and indocyanine green (ICG) fluorescence guidance. A 1-year-old boy was diagnosed with HB and multiple lung metastases. After intensive chemotherapy, complete resection with subsegmentectomy (S5 + 6) and partial resection (S3, S8) were performed. More than 100 pulmonary nodules, which remained visible on computed tomography (CT) despite additional postoperative chemotherapy, were subjected to pulmonary resection. We used the SYNAPSE VINCENT software (Fujifilm Medical, Tokyo, Japan) to obtain three-dimensional images of the nodules. We numbered each nodule, and 33 lesions of the right lung were resected by multiple wedge resections through a right thoracotomy, with the aid of palpation and ICG fluorescence guidance. One month after the right metastasectomy, resection of 64 lesions in the left lung was performed via left thoracotomy. Postoperative CT showed complete clearance of the lung lesions, and the patient remained disease-free for 15 months after the treatment. This case study confirms that the combination of three-dimensional localization and ICG fluorescence guidance allows for accurate and safe resection of nearly 100 lung metastases.
Keywords: hepatoblastoma; multiple lung metastases; three-dimensional imaging; indocyanine green hepatoblastoma; multiple lung metastases; three-dimensional imaging; indocyanine green

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MDPI and ACS Style

Komatsu, S.; Terui, K.; Nakata, M.; Shibata, R.; Oita, S.; Kawaguchi, Y.; Yoshizawa, H.; Hirokawa, T.; Nakatani, E.; Hishiki, T. Combined Use of Three-Dimensional Construction and Indocyanine Green-Fluorescent Imaging for Resection of Multiple Lung Metastases in Hepatoblastoma. Children 2022, 9, 376. https://doi.org/10.3390/children9030376

AMA Style

Komatsu S, Terui K, Nakata M, Shibata R, Oita S, Kawaguchi Y, Yoshizawa H, Hirokawa T, Nakatani E, Hishiki T. Combined Use of Three-Dimensional Construction and Indocyanine Green-Fluorescent Imaging for Resection of Multiple Lung Metastases in Hepatoblastoma. Children. 2022; 9(3):376. https://doi.org/10.3390/children9030376

Chicago/Turabian Style

Komatsu, Shugo, Keita Terui, Mitsuyuki Nakata, Ryohei Shibata, Satoru Oita, Yunosuke Kawaguchi, Hiroko Yoshizawa, Tomoya Hirokawa, Erika Nakatani, and Tomoro Hishiki. 2022. "Combined Use of Three-Dimensional Construction and Indocyanine Green-Fluorescent Imaging for Resection of Multiple Lung Metastases in Hepatoblastoma" Children 9, no. 3: 376. https://doi.org/10.3390/children9030376

APA Style

Komatsu, S., Terui, K., Nakata, M., Shibata, R., Oita, S., Kawaguchi, Y., Yoshizawa, H., Hirokawa, T., Nakatani, E., & Hishiki, T. (2022). Combined Use of Three-Dimensional Construction and Indocyanine Green-Fluorescent Imaging for Resection of Multiple Lung Metastases in Hepatoblastoma. Children, 9(3), 376. https://doi.org/10.3390/children9030376

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