Purpose or Case Report: Liver tumors account for 1-4% of all pediatrics malignancies. Most primary liver tumours in children are malignant, but one-third are benign. Mesenchymal hamartoma of the liver, though rare is the second most frequent benign liver mass in children. Generally occurs in children less than 2 years of age with a male preponderance (male: female, 2:1). We report a case of mesenchymal hamartoma of the liver in an 11 month-old female presented at the emergency department with abdominal distension of two months of evolution associated with intermittent vomiting, diarrhea and chronic malnutrition. Abnormal labs included elevated alpha-fetoprotein levels (15006 ng/ml) and non detectable beta Human Chorionic Gonadotrophin. The liver function was normal. Imaging demonstrated an abnormal abdominal X-ray, with soft tissues mass enlargement and displacement of bowel. An ultrasound revealed a mixed mass (cystic-solid) liver in segment VII. On colour-Doppler flow imaging, there was evidence of increased vascularity. Contrast-enhanced CT scan of the abdomen in arterial and venous phases showed a large cystic mass in the left lobe of the liver, with peripheral solid tissue, very vascularized in both vascular secuences. Percutaneous biopsy was done and pathology confirmed mesenchymal hamartoma. The patient underwent left hepatectomy. The patient evolved successfully.
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Conclusions: Presentamos este caso clínico porque es una enfermedad rara, con un amplio espectro de apariencias de imágenes, capaz de múltiples síntomas simulares benignas y malignas, presentando múltiples diagnósticos diferenciales. También es importante recordar la relación con el sarcoma embrionario indiferenciado. Por todo esto consideramos que el radiólogo debe tener en cuenta esta patología, lograr un diagnóstico temprano y un tratamiento preciso.