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Infantile hepatic hemangioendothelioma with elevated serum alpha-fetoprotein
Neriman Sari1, Bilgehan Yalçin, Canan Akyüz
1Hacettepe University, Institute of Oncology, Department of Pediatric Oncology, Ankara, Turkey. nerimansari1973@yahoo.com
Insights
Infantile hemangioendothelioma, a common infant liver tumor, can rarely present with elevated alpha-fetoprotein (AFP). This case highlights the need for imaging to differentiate it from hepatoblastoma in infants.
Area of Science:
- Pediatric Oncology
- Hepatology
- Vascular Malformations
Background:
- Infantile hemangioendothelioma (IHE) is the most frequent hepatic vascular tumor in infants under six months.
- Serum alpha-fetoprotein (AFP) is a key tumor marker for hepatoblastoma, hepatocellular carcinoma, and germ cell tumors.
- Elevated AFP is uncommon in IHE.
Observation:
- A case report of an infant diagnosed with hepatic hemangioendothelioma is presented.
- This infant exhibited elevated serum alpha-fetoprotein levels, a rare occurrence for this condition.
- The infant was treated with corticosteroids.
Findings:
- A solitary hepatic mass with elevated AFP in young infants does not exclusively indicate hepatoblastoma.
- This case demonstrates that IHE can be associated with significantly elevated AFP levels.
- Radiological techniques like MRI are crucial for differentiating IHE from other hepatic tumors.
Implications:
- The findings challenge the assumption that elevated AFP definitively points to malignant hepatic tumors in infants.
- Accurate diagnosis of IHE is essential to avoid unnecessary invasive procedures.
- This case underscores the importance of considering IHE in the differential diagnosis of pediatric liver masses with elevated AFP.
Abstract:
Infantile hemangioendothelioma is the most common hepatic vascular tumor in infants less than 6 months of age, with a prevalence of 1%. Serum alpha-fetoprotein levels have been used as an important tumor marker for hepatoblastoma, hepatocellular carcinoma, and germ cell tumors. It is rarely elevated in hepatic hemangioendothelioma. The authors report an infant with a hepatic hemangioendothelioma associated with elevation of serum alpha-fetoprotein who was treated with corticosteroids. In young infants, a solitary hepatic mass and elevated serum AFP level may not always be associated with hepatoblastoma. Infantile hemangioendothelioma must be differentiated by MRI or other radiological techniques before performing invasive procedures.
