SGPGIMS surgeons in Lucknow recently achieved a major milestone in pediatric cancer surgery. Specifically, they successfully treated two young patients suffering from highly complex hepatobiliary and pancreatic tumors. These successful outcomes highlight the critical role of timely clinical intervention and multidisciplinary collaboration in managing rare pediatric malignancies.

Challenging Hepatoblastoma Excision

Doctors diagnosed a 10-month-old infant from Ayodhya with hepatoblastoma. This is a rare and aggressive childhood liver malignancy. Crucially, diagnostic investigations revealed that the tumor occupied over 70% of the liver. Furthermore, the lesion lay precariously close to a major blood vessel. Because of these anatomical complexities, direct surgical resection was initially impossible. Consequently, the medical team administered four cycles of neoadjuvant chemotherapy to shrink the tumor. Subsequently, doctors performed a meticulous six-hour surgery to safely resect the mass while preserving healthy hepatic tissues. Additionally, the SGPGIMS liver transplant unit provided vital intraoperative support.

Pediatric Cancer Surgery: Whipple Procedure for SPEN

The second case involved an 11-year-old boy from Prayagraj who presented with abdominal pain, fever, and jaundice. Imaging studies identified a large solid pseudopapillary epithelial neoplasm (SPEN) obstructing the bile duct. However, SPEN is highly uncommon in male pediatric patients. Consequently, the case presented a unique diagnostic and therapeutic challenge. Ultimately, the surgical team performed an eight-hour pylorus-preserving pancreaticoduodenectomy, commonly known as a modified Whipple procedure. During this complex pediatric cancer surgery, the team successfully resected the pancreatic head mass while preserving pyloric and gastric function.

Improving Outcomes in Pediatric Oncology

Prof. Basant Kumar, Head of Pediatric Surgical Superspecialities, led both complex procedures alongside a dedicated multidisciplinary team. He emphasized that early detection is key to improving survival rates. Thus, clinicians and parents must remain vigilant regarding suspicious symptoms. For instance, warning signs include persistent abdominal pain, unexplained swelling, jaundice, recurrent fever, or rapid weight loss. Fortunately, both pediatric patients have recovered exceptionally well and continue to show positive progress during their follow-up examinations.

Frequently Asked Questions

Q1: What are the primary warning signs of pediatric gastrointestinal cancers?

Symptoms often include persistent abdominal pain, progressive abdominal swelling, unexplained jaundice, chronic recurrent fever, and rapid, unexplained weight loss.

Q2: Why is neoadjuvant chemotherapy used before liver tumor resection?

Neoadjuvant chemotherapy shrinks large tumors near major vessels. Consequently, this intervention makes the subsequent surgical resection significantly safer.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or replace professional judgment. Refer to the latest local and national guidelines for clinical practice.

References

1. Rare cancer surgeries cure 2 children at SGPGIMS - ETHealthworld


2. Pavlidis TE, et al. Current Opinion on Preservation of the Pylorus in Pancreato-Duodenectomy. Journal of Clinical Medicine Research. 2012;4(3):145-153.


3. OncoDaily Medical Journal. Treatment Outcome of Childhood Hepatoblastoma: A Single Centre Experience. 2025.