Abstract
Hepatoblastoma is a rare malignant hepatic tumor in adults. It is associated with poor prognosis as it is usually diagnosed late when the tumor is completely unresectable. Presented here, is a case of an 18-year old female with pain abdomen, vomiting, and mass over the right hypochondriac region for one month. CT scan revealed soft tissue density mass on the right lobe of liver suggestive of focal nodular hyperplasia with differential diagnosis of atypical hemangioma. Liver angiography also suggested a vascular tumor of giant hemangioma with inferior exophytic extension. The patient underwent a right extended hepatectomy. Histopathological examination revealed hepatoblastoma with predominant fetal pattern and small focal areas of embryonal pattern. The patient had an uneventful postoperative recovery and is currently undergoing chemotherapy. We present this case for its rarity and ability to masquerade other primary liver tumors in the adult age as seen in our patient.
Highlights
Hepatoblastoma is a tumor of the pediatric age group and accounts for 1-4% of all primary malignancies in children.[1]
It is postulated to arise from primary hepatoblasts or multipotent hepatic progenitor cells with the capacity to differentiate along with a variety of lineage. Since it arises in the embryo, hepatoblastoma is very rare in adults with only sixty cases reported in the literature so far.[3]
It is related to a poor prognosis with a median survival of < 5 months.[4]
Summary
Hepatoblastoma is a tumor of the pediatric age group and accounts for 1-4% of all primary malignancies in children.[1]. Liver angiography showed well defined heterogeneously enhancing mass measuring 15x14x10 cm with features suggestive of giant hemangioma with inferior exophytic extension. She underwent a right extended hepatectomy with cholecystectomy. The tumor was predominantly composed of fetal cells arranged in a nest and thin trabeculae showing characteristic alternating light and dark pattern. Multiple small focal areas of the embryonal pattern were noted These areas showed nests and lobules of tumor cells with scant cytoplasm, high nuclear-cytoplasmic ratio, and moderate to marked nuclear pleomorphism (fig 2). The final diagnosis of epithelial hepatoblastoma, mixed fetal, and embryonal subtype was reported
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