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Case Report
 
Mesenchymal hepatic hamartoma associated with elevated alpha fetoprotein mimicking a hepatoblastoma: A rare case and a literature review
 
Luvo Gaxa1, Bafana Hlatshwayo2
 
1MBChB, Mmed (Rad D,)Senior Specialist, Paediatric Radiology Fellow, South Africa
2Dip Rad Diag, MBChB, MMed Rad D, Senior Specialist, Diagnostic Radiology and Imaging, Polokwane-Mankweng Hospital Complex, Polokwane, Limpopo, South Africa

Article ID: 100034CRINTLG2017
doi:10.5348/crint-2017-34-CR-3

Address correspondence to:
Luvo Gaxa
MBChB, Mmed (Rad D) Senior Specialist
Paediatric Radiology Fellow
South Africa

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How to cite this article
Gaxa L, Hltshwayo B. Mesenchymal hepatic hamartoma associated with elevated alpha fetoprotein mimicking a hepatoblastoma: A rare case and a literature review. Case Rep Int 2017;6:9–12.


ABSTRACT
Introduction: A mesenchymal hepatic hamartoma is a heterogeneous and a rare congenital benign neoplasm whose presentation may be cystic, solid or mixed and the mass may demonstrate varying degrees of vascularity. Treating mesenchymal hepatic hamartomas conservatively is not encouraged because these lesions have the potential to grow rapidly and may degenerate to a malignant undifferentiated embryonal sarcoma. The standard treatment of mesenchymal hepatic hamartoma is surgical resection. However, marsupialization is also indicated in surgically unresectable cases.
Case Report: We report a case of one-year-old girl who presented with a one-month history of abdominal distention. The patient was born through a normal vaginal delivery at term. Apgar score 9/10-10/10, birth weight 2.8 kg. Head circumference 36 cm. The patient is retro-viral disease negative. She has normal developmental milestones and the immunizations are up to date. Ultrasound of the abdomen was performed and it showed right liver lobe large masses. Computed tomography (CT) scan was subsequently performed to further characterize the liver lesions. Ultrasound guided biopsy was performed and it confirmed the diagnosis of mesenchymal hepatic hamartoma. The alpha-fetoprotein was markedly elevated.
Conclusion: It is of utmost importance to note that as much as the mesenchymal hepatic hamartoma typically shows a normal alpha-fetoprotein, a rare presentation of this benign tumor may be associated with markedly elevated alpha fetoprotein.

Keywords: Mesenchymal hepatic hamartoma, Rare, Treatment

How to cite this article
Gaxa L, Hltshwayo B. Mesenchymal hepatic hamartoma associated with elevated alpha fetoprotein mimicking a hepatoblastoma: A rare case and a literature review. Case Rep Int 2017;6:9–12.


ABSTRACT
Introduction: A mesenchymal hepatic hamartoma is a heterogeneous and a rare congenital benign neoplasm whose presentation may be cystic, solid or mixed and the mass may demonstrate varying degrees of vascularity. Treating mesenchymal hepatic hamartomas conservatively is not encouraged because these lesions have the potential to grow rapidly and may degenerate to a malignant undifferentiated embryonal sarcoma. The standard treatment of mesenchymal hepatic hamartoma is surgical resection. However, marsupialization is also indicated in surgically unresectable cases.
Case Report: We report a case of one-year-old girl who presented with a one-month history of abdominal distention. The patient was born through a normal vaginal delivery at term. Apgar score 9/10-10/10, birth weight 2.8 kg. Head circumference 36 cm. The patient is retro-viral disease negative. She has normal developmental milestones and the immunizations are up to date. Ultrasound of the abdomen was performed and it showed right liver lobe large masses. Computed tomography (CT) scan was subsequently performed to further characterize the liver lesions. Ultrasound guided biopsy was performed and it confirmed the diagnosis of mesenchymal hepatic hamartoma. The alpha-fetoprotein was markedly elevated.
Conclusion: It is of utmost importance to note that as much as the mesenchymal hepatic hamartoma typically shows a normal alpha-fetoprotein, a rare presentation of this benign tumor may be associated with markedly elevated alpha fetoprotein.

Keywords: Mesenchymal hepatic hamartoma, Rare, Treatment


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Author Contributions
Luvo Gaxa – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data,drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Bafana Elliot Hlatshwayo – Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Luvo Gaxa et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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