Mesenchymal Hamartoma Research Articles

A rare case of mesenchymal hamartoma of chest wall in a neonate

A rare case of mesenchymal hamartoma of chest wall in a neonate

Accuracy of contrast-enhanced CT in liver neoplasms in children under 2years age.

Multiple differentials exist for pediatric liver tumors under 2years. Accurate imaging diagnosis may obviate the need for tissue sampling in most cases. To evaluate the imaging features and diagnostic accuracyof computed tomography (CT)in liver tumors in children under 2years. Eighty-eight children under 2years with treatment naive liver neoplasms and baseline contrast-enhanced CT were included in thisinstitutional review board approved retrospective study. Two blinded onco-radiologists assessed these tumors in consensus. Findings assessed included enhancement pattern, lobulated appearance, cystic change, calcifications, central scar-like appearance, and metastases. The radiologists classified the lesion as hepatoblastoma, infantile hemangioma, mesenchymal hamartoma, rhabdoid tumor, or indeterminate, first based purely on imaging and then after alpha-fetoprotein (AFP) correlation. Multivariate analysis and methods of comparing means and frequencies were used for statistical analysis wherever applicable. Diagnostic accuracy, sensitivity, and positive predictive values were analyzed. The mean age of the sample was 11.4months (95% CI, 10.9-11.8) with 50/88 (57%) boys. The study included 72 hepatoblastomas, 6 hemangiomas, 4 mesenchymal hamartomas, and 6 rhabdoid tumors. Presence of calcifications, multilobular pattern of arterial enhancement, lobulated morphology, and central scar-like appearance was significantly associated with hepatoblastomas (P-value < 0.05). Fourteen out of eighty-eight lesions were called indeterminate based on imaging alone; six lesions remained indeterminate after AFP correlation. Pure radiology-based diagnostic accuracy was 81.8% (95% CI, 72.2-89.2%), which increased to 92.1% (95% CI, 84.3-96.7%) (P-value > 0.05) after AFP correlation, with one hepatoblastoma misdiagnosed as a rhabdoid tumor. If indeterminate lesions were excluded for biopsy, the accuracy would be 98.8% (95% CI, 93.4-99.9%). CT had high accuracy for diagnosing liver neoplasms in the under 2-year age population after AFP correlation. Certain imaging features were significantly associated with the diagnosis of hepatoblastoma. A policy of biopsying only indeterminate lesions after CT and AFP correlation would avoid sampling in the majority of patients.

Rhabdomyomatous Mesenchymal Hamartoma: Report of 4 Cases With Histochemical and Immunohistochemical Findings and Emphasis on Potential Pitfalls.

Rhabdomyomatous mesenchymal hamartoma (RMH) typically presents as a congenital midline head and neck cutaneous polyp in infants. Perianal and mucocutaneous lesions have been reported, and recently, acquired adult-onset variants have been proposed. This makes the true prevalence, etiopathogenesis, and clinicopathologic distribution and classification of RMHs in children compared with those in adults uncertain. We performed a retrospective review to highlight the salient histopathologic, histochemical, and immunohistochemical features in RMHs and to emphasize their specific clinicopathologic criteria to avoid diagnostic pitfalls. We found 4 (0.3%) infants [2 female infants and 2 male infants, average age: 4 months] with mental, nasal, lingual, and perianal midline RMHs (average size: 1.0 cm) of 1303 patients with cutaneous polypoid lesions. Three were isolated, and 1 was associated with Goldenhar syndrome. The cutaneous polyps demonstrated intermixed skeletal muscle, adipose, and fibrocollagenous core stroma that extended into the dermis and around the dermal appendages. The lingual lesion demonstrated skeletal muscle and fibrocollagenous stroma with prominent nerve bundles and little adipose tissue. All showed interstitial loose mesenchyme. Masson trichome demarcated the triphasic stromal components. Alcian blue demonstrated the loose myxoid mesenchyme. Elastic van Gieson did not show elastic fibers. Desmin demonstrated the skeletal muscle bundles, S100 highlighted the adipose tissue lobules and the nerve bundles, and CD34 displayed the mesenchymal stroma. Ki67 showed a low proliferation index in the loose mesenchyme. Smooth muscle actin did not reveal smooth muscle bundles, but with CD31, they highlighted the thick blood vessels. CD117 revealed prominent mast cells. From our retrospective review series, 4 cases that originally diagnosed as RMHs were excluded. Likewise, we found some examples of the reported cases in the English literature that might have been mistaken for RMHs. This is because they did not fulfill the diagnostic clinicopathologic criteria. RMH constitutes a rare entity with specific clinicopathologic features. Most lesions are isolated. Some are associated with congenital anomalies and syndromes. Strict clinicopathologic diagnostic criteria should be applied to avoid mislabeling look-alike lesions for RMHs.

Clinical characteristics, diagnosis and treatment of nasal cartilage mesenchymal hamartoma in infants

Objective: To explore the clinical characteristics, pathological features, and diagnosis and treatment strategies of nasal chondromesenchymal hamartoma (NCMH) in infants and young children. Methods: A retrospective analysis was conducted on seven cases of NCMH infants and young children admitted to Beijing Children's Hospital, Capital Medical University from April 2015 to January 2022. The cohort included 5 males and 2 females, aged from 6 days to 2 years and 3 months. General information, clinical symptoms, imaging findings, treatment plans, postoperative complications, recurrence and follow-up time were collected, summarized and analyzed. Additionally, immunohistochemical characteristics of the lesion were examined. Results: The clinical symptoms of 7 children included nasal congestion, runny nose, open mouth breathing, snoring during sleep, difficulty feeding, and strabismus. All patients underwent electronic nasopharyngoscopy examination, with 5 cases of tumors located in the right nasal cavity and 2 cases in the left nasal cavity. No case of bilateral nasal cavity disease was found. All 7 patients underwent complete imaging examinations, with 5 patients underwent MRI and CT examinations, 1 patient underwent CT examination only, and 1 patient underwent MRI examination only. The CT results showed that all tumors were broad-based, with uneven density, multiple calcifications and bone remodeling, and some exhibited multiple cystic components. The MRI results showed that the tumor showed low signal on T1 weighted imaging and high or slightly high signal on T2 weighted imaging. All patients were diagnosed through histopathological examination and immunohistochemistry, including 7 cases of Ki-67 and SMA (+), 5 cases of S-100 and Vimentin (+), and all EMA and GFAP were negative. All patients underwent endoscopic resection surgery through the nasal approach, with 3 cases using navigation technology. Five cases of tumors were completely removed, and two cases of tumors were mostly removed. No nasal packing was performed after surgery, and no postoperative nasal, ocular, or intracranial complication occurred in all patients. Follow up assessments conducted 6 to 84 months post-surgery revealed no instances of tumor recurrence in any of the patients. Conclusions: The clinical symptoms of children with NCHM mainly depend on the size and location of the tumor. Nasal endoscopic surgery is the main treatment method. In cases where critical structures like the skull base or orbit are implicated, staged surgical interventions may be warranted. Long-term follow-up is strongly advised to monitor for any potential recurrence or complications.

Interventional Radiology Management of Pediatric Liver Tumors

AbstractPediatric liver tumors are not only rare, they are also different from the adult liver tumors. Hepatoblastomas and hepatocellular carcinomas (HCCs) are the most common primary malignant tumors seen in children. Fibrolamellar HCC, sarcomas, cholangiocarcinoma, germ cell tumor, and rhabdoid tumor and metastatic tumors comprise the remainder of liver malignancies. Hepatic infantile hemangiomas, mesenchymal hamartoma, regenerative nodules, adenomas, and focal nodular hyperplasia are the common benign liver tumors of childhood. The Pediatric Hepatic International Tumour Trial (PHITT) is an international trial with the goal of evaluating new and existing treatments for pediatric liver tumors. Chemotherapy, surgery, and liver transplantation are well-established in the management of pediatric liver tumors. In the background of increasing incidence of pediatric tumors, and availability of newer, less invasive modalities to treat tumors, it is vital to understand the role of interventional radiology in the management of pediatric liver tumors.

Mesenchymal Cystic Hamartoma of the Lung

Mesenchymal cystic hamartoma, which was first described in 1986, is a very rare pulmonary pathology. To date, a little more than 20 cases have been registered in the literature. The disease usually has an asymptomatic course, but can potentially lead to severe pulmonary bleeding and even death. It has no specific radiological signs, therefore it is necessary to carry out differential diagnosis with other diseases, including malignant neoplasms. We present our own clinical observation of this pathology.

Clinicopathological analysis of adult hepatic mesenchymal hamartoma

Objective: To explore the clinicopathological and molecular genetic features of adult hepatic mesenchymal hamartoma (MHL). Methods: A total of five confirmed adult MHL cases diagnosed at the Pathology Department of the First Medical Center of the People's Liberation Army General Hospital between 2009 and 2022 were collected. Histomorphological observation and immunohistochemical staining were conducted. Gene detection was performed by next-generation sequencing. Results: Among the five cases, four were male and one was female, aged 46-67 years, with an average age of 56.2 years. The maximum diameter was 5.3-13.5cm, and the average diameter was 9.2cm. Tumors were generally cystic, solid, or mixed cystic-solid. Histopathologically, in four out of five cases of MHL, malignant transformation occurred, of which three cases were malignantly transformed into undifferentiated embryonal sarcoma and one case was malignantly transformed into a malignant solitary fibrous tumor. NAB2-STAT6 gene rearrangements were identified. Conclusion: Adult MHL is a rare kind of tumor with malignant potential, and it is difficult to diagnose with preoperative imaging examinations. A fine-needle biopsy is rarely used for diagnosis, but surgical resection of symptomatic or enlarged lesions is recommended to rule out the possibility of malignancy and further diagnosis. Genetic testing results revealed the complex genetic alterations in MHL, and it was found that adult MHL can malignantly transform into malignant solitary fibrous tumors. We believe that genome-wide analysis is necessary to determine the unique molecular characteristics of MHL and identify potential targets for therapeutic intervention.

Role of Mesohepatectomy for Pediatric Centrally Located Liver Tumors.

Mesohepatectomy (MH) or central hepatectomy (CH) is a recognized surgical technique for centrally located pediatric liver tumors. This technique of liver resection avoids extended liver resections and thereby helps in the preservation of liver parenchyma. In this article, we aim to analyze our experience and outcome with this technique of liver resection. A retrospective analysis of patients who underwent MH from January 2015 to June 2023 at our institute was performed. The variables analyzed include demographics, preoperative treatment, perioperative management, and postoperative outcome. A total of five patients underwent CH. Four patients had hepatoblastoma, and one patient had mesenchymal hamartoma. All four patients with hepatoblastoma received neoadjuvant chemotherapy. All five patients had negative surgical margins, and one of the five developed disease recurrences necessitating resurgery and ultimately died of metastasis. one patient sustained intraoperative major bile duct injuries, and one patient had postoperative Abnormal, well-circumscribed, extra-biliary collection of bile. MH with clear margins is feasible in the selected subset of pediatric liver tumors involving segments IV, V, and VIII with outcomes equivalent to extended hepatic resections.

Congenital Tumors-Magnetic Resonance Imaging Findings with Focus on Rare Tumors.

Congenital tumors are rare and, owing to this rarity, there is limited information on many of them. A total of 839 fetal and postnatal MRI studies performed in the first 3 months of life were retrospectively reviewed. They were performed with the use of 1.5 T scanners. Seventy-six tumors were diagnosed based on fetal MRI between 20 and 37 gestational weeks, and 27 were found after birth, from 1 day of age to 3 months of life. Teratomas were the most common tumors in our dataset, mainly in the sacrococcygeal region (SCT), followed by cardiac rhabdomyomas and subependymal giant cell astrocytomas (SEGA) associated with TSC, and neuroblastomas. The group of less common tumors consisted of infantile fibrosarcomas, malignant rhabdoid tumors, mesoblastic nephromas and Wilms tumor, craniopharyngiomas, brain stem gliomas, desmoplastic infantile astrocytoma, choroid plexus carcinoma, glioblastoma, hemangiopericytoma, rhabdomyosarcoma, melanoma, mesenchymal hamartomas of the chest wall and the liver, and juvenile xanthogranuloma, with special consideration of blue rubber bleb nevus syndrome. MRI plays a significant role in further and better characterization of congenital tumors, leading to a correct diagnosis in many cases, which is crucial for pregnancy and neonatal management and psychological preparation of the parents. No diagnosis is impossible and can be absolutely excluded.

Paediatric Mesenchymal Hamartoma of Liver-A Diagnostic Dilemma

Introduction and Importance: Benign tumors of the liver are relatively rare in children. Mesenchymal hamartoma (MH) is a benign tumor of the liver. It is the second most common benign pediatric hepatic tumor after infantile hemangioma. Mostly it is seen in children less than 2 years of age. The diagnosis of this tumor is difficult because of nonspecific clinical symptoms and lack of definitive laboratory studies. The precise diagnosis of mesenchymal hamartoma relies on histological evaluation of the tissue.We hereby present a rare case in a 2 year old child with mesenchymal hamartoma and its diagnostic challenges. Case presentation: A 2 year old previously healthy male was referred to our institution for evaluation of a liver mass. He complained of loss of apetite and abdominal distension since last 10 weeks. He had no complaints of fever/trauma. Clinical findings and Investigations: On per abdomen examination,there was a presence of large, non tender hepatomegaly with no shifting dullness present. On radiological evaluation, Ultrasound abdomen showed solitary right lobe mass. On further imaging, CT scan of the abdomen was done which showed a large multiloculated lesion in right lobe liver with arterial enhancing intervening septae within.The lesion was compressing and displacing right portal vein and right hepatic vein. At that time, laboratory evaluation showed normal liver function tests, serum AFP and other blood parameters. Differentials of liver cyst, hydatid cyst and biliary cystadenoma was made. Intervention and outcome: After discussion in multidisciplinary care, he was planned for surgery which would provide the exact histological diagnosis also in such cystic lesion of liver.He was optimized for surgery and subsequently underwent right hepatectomy with resection of the ~14× 12 cm mass. No major periperative complications developed and patient was discharged from hospital on POD6. The pathological review of the resected mass showed mixture of bile ducts, vessels, irregular liver cell plates and loose mesenchyme containing variable sized cysts consistent with a mesenchymal hamartoma. He is asymptomatic at the time of regular follow-up visits. Relevance and Impact: Benign tumors of the liver are relatively rare in children. The diagnosis of mesenchymal hamartoma still remains a challenge with non –specific complaints, normal laboratory findings and delay in diagnosis can lead to complications from local compression. Though advance imaging can diagnose this entity if index of suspicion is high but Differentiating it from other tumors such as an undifferentiated embryonal sarcoma is difficult on imaging alone. Hence surgical excision is the gold standard for diagnosing to reach the final histological diagnosis and treating these entities.

Hepatic mesenchymal hamartoma masquerading as neonatal unconjugated hyperbilirubinemia: a case report

BackgroundHepatic mesenchymal hamartoma (HMH) is the second most common benign hepatic tumor in the pediatric age group. The etiology of HMH is unclear. Theories include abnormal hepatic mesenchyme, a reactive change or a proliferative lesion. The condition can present prenatally in USG as a mass, high output cardiac failure, pulmonary hypertension, respiratory distress, and abdominal distension or mass in older children. We present this case to discuss an extremely rare presentation of a comparatively rare disease and to emphasise the need for a high index of suspicion even if the patient presents with symptoms common for that age.Case presentationA 7-day-old male baby with an uneventful antenatal period, born by vaginal delivery, with a birth weight of 3.1 kg and normal APGAR scores, presented with jaundice, poor feeding, and labored breathing noticed on the same day itself. Examination revealed a grossly distended abdomen with a mass of size 8 × 7 cm occupying the right side down to the right iliac fossa, crossing midline and dullness continuous with liver dullness. On investigation an abnormal liver function test with unconjugated hyperbilirubinemia was seen. USG and CECT abdomen were suggestive of HMH with close proximity to hepatic vessels. Exploratory laparotomy and near total excision with marsupialisation was done. Histopathology report was suggestive of HMH. A 2-year follow-up was normal.ConclusionThis case of HMH presented as neonatal jaundice with unconjugated hyperbilirubinemia which is a rarity. We had to limit our surgery to near total excision and marsupialisation due to its proximity to vascular structures.

Bilateral mesenchymal hamartoma of chest wall in a toddler: An uncommon clinical entity

Aim- Background: Bilateral chest wall mesenchymal hamartoma is a very rare lesion of infancy with distinct clinical, radiologic and pathologic characteristics. Computed tomography of the thoracic cavity is a very useful diagnostic tool. Histopathology examination offers the definite diagnosis. Report of a case: Herein we present a pediatric case of congenital bilateral mesenchymal hamartoma of the chest wall in a toddler. Both chest masses were surgically removed, when the boy appeared having clinical manifestations and respiratory compromise. As a result, the patient got fully recovered and free of any symptoms. Conclusions: As far as treatment of this uncommon tumorous condition is concerned, it is strongly supported that asymptomatic cases should be conservatively managed with close follow-up and periodic imaging. On the contrary, in cases presenting with clinical features, complete surgery treatment should be initiated and applied aiming the ultimate cure.

Outcomes of Primary Tumor Excision do not Differ from Non-Resection Methods in Pediatric Mesenchymal Hamartoma of the Liver: A Rapid Systematic Review

BackgroundTo conduct a rapid systematic review comparing the outcomes of primary tumor resection versus non-resection on patients with hepatic mesenchymal hamartoma. MethodsWe searched the Ovid MEDLINE, EMBASE, Scopus, PubMed, Web of Science, and Google Scholar databases from January 1, 2000 to March 31, 2022. Studies that described cases of hepatic mesenchymal hamartoma, including management and outcomes, were included. Results62 articles met inclusion criteria with 95 cases in total. Patients were assigned to the primary tumor resection (n = 85) or non-resection (n = 10) cohort based on the described management. Similar rates of morbidity (17% vs 20%) and mortality (6 vs 10%) were identified between cohorts. There were no differences in sex, liver lobe involvement, or tumor size among study groups. ConclusionsComplete tumor resection should remain the gold standard for hepatic mesenchymal hamartomas when an adequate liver remnant exists. Reports of non-resected tumors demonstrating spontaneous regression or stability with watchful waiting have poor long term follow-up and have inadequate evidence of a true mesenchymal hamartoma diagnosis. Level of EvidenceLevel I.

Surgical treatment of rare benign right ventricular tumors in infants: two case reports

Objective: To describe rare clinical and morphological forms of right ventricular neoplasms (mesenchymal hamartoma, rhabdomyoma) in infants which required surgical treatment in infancy.Methods: We performed 2 radical operations to remove right ventricular neoplasms: neonatal mesenchymal hamartoma and infantile rhabdomyoma.Results: We confirmed the effectiveness of surgery for rhabdomyoma and mesenchymal hamartoma in infants based on an 11-year postoperative follow-up period. We followed a necessary search strategy to detect tuberous sclerosis complex often associated with rhabdomyoma.Conclusion: Surgical treatment of rare right ventricular neoplasms in infants demonstrated favorable long-term results. Received 29 December 2022. Revised 22 February 2023. Accepted 27 March 2023. Informed consent: The patients' mothers informed consent to use the records for medical purposes is obtained. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsLiterature review: E.A. Enin, A.V. MishinDrafting the article: A.V. MishinCritical revision of the article: K.N. Kuatbekov, E.A. Enin, A.L. Egizekov, A.A. SarsembayevaSurgical treatment: K.N. Kuatbekov, A.V. MishinFinal approval of the version to be published: K.N. Kuatbekov, E.A. Enin, A.L. Egizekov, A.V. Mishin, A.A. Sarsembayeva

Mesenchymal Hamartoma of the Liver Associated with Discontinuity of the Vena Cava

Primary liver tumors in children are infrequent, accounting for 0.5-2 % of all pediatric neoplasms. About two-thirds are malignant. The most common pediatric malignant liver tumours are, in order of frequency, hepatoblastoma, hepatocellular carcinoma, and embryonic sarcoma of the liver. Among benign tumors, the most frequent are hemangioendothelioma and mesenchymal hamartoma of the liver, and more rarely focal nodular hyperplasia and hepatocellular adenoma [1,2]. We report the case of an infant who was entrusted to us for the management of a large liver tumor. Radiology (CT scan and MRI), in addition to the elements in favor of a mesenchymal hamartoma of the right liver revealed a congenital anomaly associated, in this case, with the absence of the inferior vena cava in its intraabdominal portion. A right hepatectomy enlarged to segment IV was performed. The right renal vein drained into the right suprahepatic vein was preserved. Note that this tumor represents 50% of the total weight of the patient, which explains the difficulties and constraints that hindered the development and quality of life of the young patient.

Pediatric hepatic vascular tumors: clinicopathologic characteristics of 33 cases and proposed updates to current classification schemes

Pediatric hepatic vascular tumors (HVTs) are rare neoplasms with features distinct from their cutaneous counterparts. Their behavior ranges from benign to malignant, with each subtype having therapeutic differences. Histopathologic descriptions of large cohorts are scarce in the literature. Thirty-three putative HVTs diagnosed from 1970 to 2021 were retrieved. All available clinical and pathologic materials were reviewed. Lesions were reclassified according to the World Health Organization (WHO) classification of pediatric tumors [1] ashepatic congenital hemangioma (HCH; n=13), hepatic infantile hemangioma (HIH; n=10), hepatic angiosarcoma (HA; n=3), and hepatic epithelioid hemangioendothelioma (HEH; n=1). Vascular malformations (n=5) or vascular-dominant mesenchymal hamartoma (n=1) were excluded. HCH frequently showed involutional changes, whereas HIH often had anastomosing channels and pseudopapillae formation. HA had solid areas with epithelioid and/or spindled endothelial morphology, significant atypia, increased mitoses, high proliferation index, and occasionally necrosis. On morphology analysis, a subset of HIH showed features worrisome for progression to HA including solid glomeruloidproliferation, increased mitoses, and epithelioid morphology. The widely metastatic and fatal HEH was observed in a 5-year-old male with multiple liver lesions. Immunohistochemically, HIHs and HA were Glucose transporter isoform 1 (GLUT-1) positive. One HIH patient died from postoperative complications, whereas 3 are alive without disease. Five HCH patients are alive and well. Two of three HA patients died of disease, and 1is alive without recurrence. To our knowledge, this is the largest series of pediatric HVTs reviewing clinicopathologic features based on current Pediatric WHO nomenclature [1]. We highlight diagnostic challenges and propose inclusion of an intermediate category between HIH and HA which warrants closer follow-up.

Mesenchymal cystic hamartoma of the lung mimicking simple pulmonary aspergilloma: a case report

BackgroundMesenchymal cystic hamartoma is a rare pulmonary neoplasm, which occasionally presents with severe symptoms such as pneumothorax or hemothorax, and shows favorable outcomes following surgical resection. It presents as solitary or multiple cystic lesions and requires differentiation from cystic malignancies, lymphangiomyomatosis, and cystic adenomatoid malformation.Case presentationWe encountered a 46-year-old woman with mesenchymal cystic hamartoma mimicking simple pulmonary aspergilloma on diagnostic imaging. Chest computed tomography showed a cystic lesion 1.6 cm in diameter, with an intracavitary nodule. Surgical resection proved neither fungus nor malignancy, and the final pathological diagnosis of mesenchymal cystic hamartoma was made.ConclusionsMesenchymal cystic hamartoma might show aspergilloma-like features on diagnostic imaging, in addition to the differential diagnosis of lung cancer.

Hydatid Disease: A Radiological Pictorial Review of a Great Neoplasms Mimicker

Hydatid cyst is a common name for the larval stage of a tapeworm species of Echinococcus granulosus, which is transmitted from animals to humans via the fecal-oral route. Hydatid cysts predominantly affect the liver (75%), followed by the lung (15%), and they can affect many organs in the human body. Medical imaging modalities are the keystone for the diagnosis of hydatid cysts with high sensitivity and specificity. Ultrasound imaging with high resolution is the first choice for diagnosis, differential diagnosis, staging, establishing a role in interventional management, and follow-up, and it can differentiate Type I hydatid cysts from simple liver cysts. Unenhanced computed tomography (CT) is indicated where or when an ultrasound is unsatisfactory, such as with chest or brain hydatid cysts, when detecting calcification, and in obese patients. Magnetic resonance imaging (MRI) is superior for demonstrating cyst wall defects, biliary communication, neural involvement, and differentiating hydatid cysts from simple cysts using diffusion-weighted imaging (DWI) sequences. According to the phase of growth, hydatid cysts occur in different sizes and shapes, which may mimic benign or malignant neoplasms and may create diagnostic challenges in some cases. Hydatid cysts can mimic simple cysts, choledochal cysts, Caroli's disease, or mesenchymal hamartomas of the liver. They can mimic lung cystic lesions, mycetoma, blood clots, Rasmussen aneurysms, and even lung carcinomas. Differential diagnosis can be difficult for arachnoid cysts, porencephalic cysts, pyogenic abscesses, and even cystic tumors of the brain, and can create diagnostic dilemmas in the musculoskeletal system.

Mesenchymal Hamartoma of the Liver Incidentally Discovered in a 4 Year Old Girl: Management and Treatment

Abstract Mesenchymal hamartomas of the liver is considered a benign tumour, although it provides significant challenges in the diagnosis and operative management. Clinical features, laboratory results and radiographic imaging are often non-specific and inconclusive. Thus, it is still difficult to differentiate from malignant lesion without pathological examination. While this tumour is usually diagnosed in the first 2 years of life, few cases in older children have been reported and most of them are case reports. In this article, we want to report our clinical evaluation, results of image diagnosis, surgical procedure and the follow-up simultaneously we discuss the possible differential diagnosis of such a case at this age.

Clinicopathological analysis of mesenchymal hamartoma of the liver

Clinicopathological analysis of mesenchymal hamartoma of the liver