Severe Infantilehepatic Hemangioma or Hepatoblastoma: About a Rare Case and Literature Review

Abstract

Childhood liver tumors are rare, but two-thirds are of malignant origin. Basically, before the age of 3, the main diagnoses are Hepatoblastoma (HB) and hemangioma. Infantile Hepatic Hemangioma (HHI) is a subclass of infantile hemangiomas that are the most common self-limiting benign tumors of early childhood. Only the diffuse forms or associated with congestive heart failure can be fatal. Careful clinical examination associated with biological and radiological elements does not always allow a diagnosis to be made. The biopsy is still performed frequently for diagnostic or prognostic purposes. Because of the diagnostic difficulties with HB, and the severity of some forms of HHI, we report the case of a newborn with diffuse HHI, observed at the Cheikh Khalifa International University Hospital in Casablanca. This was a newborn male in whom symptomatology of the disease consisted of increased abdominal volume, hepatomegaly and signs of respiratory struggle. The ultrasound described the existence of a multi-hetero-nodular hepatomegaly, and the CT scan a liver increased in size, seat of a large mass, poorly limited with bumpy contours of predominant tissue density with individualization of a central area of fluid density necrosis, containing calcifications. The AFP rate was high. An ultrasound-guided percutaneous biopsy confirmed the diagnosis of HHI. The course was very rapid and fatal in this patient with diffuse HHI with congestive heart failure.