engleski

A case of pedunculated hepatic mesenchymal hamartoma in a child

Objective: Liver tumors are uncommon during childhood, when they show an age-dependent distribution and are mostly malignant. Hepatic mesenchymal hamartoma (HMH) is a rare benign lesion, presumably congenital, usually occuring under the age of 2. There is still no agreement upon its histogenesis, whether it represents developmental anomaly, true neoplasm or reactive lesion resulting from biliary obstruction or anomalous blood supply. Results: A 1-year-old boy was admitted due to acute abdomen. Clinical investigation revealed a hepatic tumor (US, MR) which was surgically removed. The tumor was torquated around a stalk connected to falciform ligament, and adherent to omentum and transverse colon. Grossly, it had gray-brown, glistening, lobular surface and measured 6x5, 5x4, 5 cm. The cut-surface was necrotic and hemorrhagic, with only a narrow rim of preserved solid tissue at the periphery. Histologically, it was composed of abundant, myxoid and loose stroma with focally dilated bile ducts, sparse cords of hepatocytes and numerous blood vessels, some of which thrombosed. There were only a few mitotic figures, but no atypia. No extramedullary haematopoiesis was noted. The tumor margins were positive. Conclusion: Unlike classic HMH showing multiple cysts, sometimes resembling lymphangioma, the tumor in our case was solid and pedunculated. Although the lesion is benign and should not recur, since it may rarely progress into malignancy, we believe our patient should be followed-up for a longer period.

mesenchymal hamartoma; liver; child

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