Solid mesenchymal hamartoma in an adult: a case report

Area of Science:

• Hepatobiliary Medicine
• Surgical Pathology
• Pediatric Oncology (rare adult presentation)

Background:

• Mesenchymal hamartoma of the liver (MHL) is a rare liver tumor characterized by abnormal bile ducts within a myxoid stroma.
• While predominantly diagnosed in children, MHL can uncommonly present in adults, posing diagnostic and therapeutic challenges.
• Adult MHL cases are exceptionally rare, with limited literature available for guidance.

Observation:

• This report details a case of a 51-year-old male presenting with a large, completely solid liver mass in the right lobe.
• Preoperative imaging and biopsy revealed features suggestive of MHL, including a dense fibrous stroma with hyalinization and bile ducts.

Findings:

• Surgical excision was not feasible due to the mass's characteristics.
• The patient underwent liver transplantation, and definitive pathology confirmed the diagnosis of MHL.
• This represents the fourth reported case of MHL managed with liver transplantation in the literature.

Implications:

• The case underscores the importance of considering MHL in adult liver masses, even when rare.
• Liver transplantation is a viable, albeit uncommon, treatment option for adult MHL when resection is not possible.
• Further research into adult MHL presentation and management may improve diagnostic accuracy and treatment strategies.