Beaumont Children’s Hospital surgical team removes rare liver tumor in Commerce Township infant

5/1/2014

It was supposed to be a routine wellness visit. Baby Kaden, Stacy Rennie’s 9-month-old son, needed a vaccination. So routine, she decided to have her husband, Jason, take him to their pediatrician for his flu shot.

Their doctor had questions about Kaden, Jason couldn’t answer. So, they called Stacy at home, not once, but twice. Stacy could hear the concern in her pediatrician’s voice and then realized it was anything but routine.

During Kaden’s abdominal exam, the doctor noticed his stomach seemed bloated and didn’t feel right. This was followed up with an X-ray. The image confirmed the doctor’s suspicion that something was wrong. Kaden was referred to Beaumont for an ultrasound.

A short time after Kaden’s ultrasound, he was admitted to Beaumont Children’s Hospital in Royal Oak. The imaging confirmed a large mass, nearly 6 inches in length, in the right lobe of the infant’s liver.

“All of a sudden our lives just sort of stopped,” recalls Stacy of Commerce Township. “We heard talk about the tumor and its size. Was it benign or malignant? And we heard words we didn’t want to hear - cancer, chemotherapy.”

Then, an MRI was ordered. Adds Stacy, “It was a parent’s worst nightmare.”

“Compared to Kaden’s small stomach, the tumor was huge. With a mass that large, it’s hard. We often think about the worst case scenario – cancer in the right and left lobe, chemotherapy, or the possibility of a liver transplant,” says Anne Fischer, M.D., Ph.D., surgeon-in-chief, Beaumont Children’s Hospital. “There is always the fear of hepatoblastoma, a childhood liver cancer. For parents, like the Rennies, it can be a total roller coaster of emotion.”

But, the results of the MRI brought some relief to Stacy and Jason Rennie. While the mass, or tumor, filled little Kaden’s abdomen all the way down to his hip bone, the medical team were optimistic it was not cancerous. This also meant the surgery would not have to be performed immediately.

Based on the images and blood tests measuring tumor protein, Dr. Fischer was more confident that the mass was a mesenchymal hamartoma of the liver. These types of pediatric tumors are noncancerous and rare.

Explains Dr. Fischer, “This congenital condition was last seen here at Beaumont about 10 years ago. It is caused by immature, primitive cells that don’t know when to stop growing, and in Kaden’s case, filling one-half of his abdomen and pushing his organs. The cell has no stop function, resulting in large masses, like Kaden’s.”

Kaden and his father, Jason, with Dr. Fischer for a postop visit

Dr. Fischer shared her concerns about this type of tumor, “It has great growth potential. Left untouched, the large tumor could affect the function of Kaden’s liver. Although not a cancer now, it has a chance to degenerate into a sarcoma.”

As a surgeon, she wondered whether the tumor could be resected, or cut away, without affecting vital structures in the liver. It’s important to note that the liver is the only vital organ in the body that can regenerate itself in about two to three weeks.

Says Dr. Fischer, “This complex case exemplifies the advanced surgical capabilities of Beaumont Children’s Hospital and its multidisciplinary team. It’s a great example of collaboration.”

On January 29, Dr. Fischer worked with Alan Koffron, M.D., liver surgeon and Beaumont Health System’s chairman of Surgery, along with pediatric surgeon Robert Morden, M.D., to surgically remove Kaden’s liver tumor.

Thanks to state-of-the-art technology, including intraoperative imaging, the nearly three-hour procedure was a success. The surgical ultrasound confirmed the critical hepatobiliary structures and vessels close to the tumor, allowing them to remove the entire mass without affecting vital structures in the liver and with minimal blood loss.

Stacy and Jason were not only surprised, but appreciative when all the doctors came out to discuss Kaden’s surgery.

“They saved his life,” says a grateful Stacy. “We’re definitely blessed.”