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Use of Gemcitabine With Multi-stage Surgical Resection as Successful Second-line Treatment of Metastatic Pancreatoblastoma

Belletrutti, Mark J. MD; Bigam, David MD; Bhargava, Ravi MD; Grundy, Paul MD

Journal of Pediatric Hematology/Oncology: January 2013 - Volume 35 - Issue 1 - p e7–e10
doi: 10.1097/MPH.0b013e3182707577
Online Articles: Clinical and Laboratory Observations

Pancreatoblastoma is a rare pediatric pancreatic malignancy. It confers a worse prognosis if there is metastatic or unresectable disease. We report a case of a 12-year-old boy who presented with pancreatoblastoma of the head of the pancreas with multiple intrahepatic metastases. We successfully treated him using aggressive chemotherapy, multi-stage surgery, and gemcitabine chemotherapy, which has not been described as treatment for pancreatoblastoma. Rare childhood malignancies such as pancreatoblastoma require a coordinated, multidisciplinary approach and frequent reassessment of therapeutic interventions. Complete surgical resection is important for cure and may require complex, aggressive, multiple-stage surgical procedures with concurrent or novel chemotherapy.

*Department of Pediatrics, Division of Pediatric Hematology, Oncology and Palliative Care

Department of Radiology and Diagnostic Imaging, Division of Pediatric Radiology, Stollery Children’s Hospital

Department of Surgery, Division of General Surgery, University of Alberta Hospital, University of Alberta, Edmonton, AB, Canada

The authors declare no conflict of interest.

Reprints: Mark J. Belletrutti, MD, Department of Pediatrics, Division of Pediatric Hematology, Oncology, and Palliative Care Stollery Children’s Hospital, 3-511 Edmonton Clinic Health Academy, 11405 87 Avenue NW, Edmonton, AB, Canada T6G 1C9 (e-mail:

Received October 6, 2011

Accepted August 22, 2012

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.