A Malignant Hepatoblastoma Mimicking a Benign Mesenchymal Hamartoma:
Lessons Learned
Abstract
Differentiating hepatoblastomas (HB) from other congenital benign
hepatic tumours prior to surgical management decisions is key. We,
herein, present an unusual case of an antenatally diagnosed liver lesion
assessed in the neonatal period. Because of its predominantly cystic
ultrasound/MRI appearance and borderline alpha-fetoprotein serum levels,
the diagnosis of mesenchymal hamartoma was favoured and protocol-based
tumor resection was performed. Due to the intra-operative diagnosis of
fetal subtype HB with positive resection margins the child had to
undergo a second laparotomy. This report raises awareness to an unusual
appearance of HB and discusses non-invasive imaging clues to consider
atypical appearances of HB pre-operatively as they can have profound
implications in patient management.