Thursday, 14 May 2020

CASE 584: INFANTILE MESENCHYMAL HAMARTOMA IN LIVER, Dr PHAN THANH HẢI, Dr LÊ THANH LIÊM, Prof NGUYỄN SÀO TRUNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


Male child 3 months old, well feeding and weight .
Dr Truong Dinh Khai [Children Hospital N2] detected liver lesions with high level of AFP, suspected hepatoblastoma. But Wako tests= AFP 6,388.4; AFP L3 and DCP in normal values.

At Medic, ultrasound thought about infectious lesions in right lobe #56x53mm, solid, septation with cystic appearance. 




MRI (Gado)= Right lobe of liver lesions may belong to mesenchymal sarcoma, AFP  got down <2,000.



Operation for removing liver tumor.
Macro and microscopic specimens with results are Mesenchymal Hamartoma in liver.
The specimen composes of cords of normal hepatocytes with loose cellular parenchyme, congestive blood vessels, hyalynized fibrous tissue.

2 months post op selective hepatectomy, in reexamination check-up, regular weight gain normaly # 8kg of 5.5 months old, AFP downed at 44 ng/mL (last time 74ng/mL). Not detected relapse tumor. 

Conclusion :

Hepatic Mesenchymal Hamartoma is a rare benign tumor in children. Tumor appeares in big cyst, septated  or solid matter with small cysts.  Hepatic mesenchymal sarcoma is a different diagnostic item with asthenia, invasion to vessels, biliary obstruction.


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