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Antenatal diagnosis of congenital hepatic hemangioma: a case report
Sofia Vargas Cabrita1, Sónia Gonçalves, Henrique Rodrigues
1Obstetrics Department of University Hospital of Coimbra, Rua Miguel Torga, 3030-165, Coimbra, Portugal. sofiacba@gmail.com
Insights
This case study highlights the antenatal diagnosis of a fetal hepatic hemangioma, a rare liver tumor in infants. Early detection via ultrasound enabled timely management and a positive outcome for the child.
Area of Science:
- Pediatric Oncology
- Fetal Medicine
- Diagnostic Imaging
Background:
- Hepatic tumors are rare in children, comprising 1-5% of pediatric tumors.
- Hepatic hemangioma is the third most common liver tumor in childhood.
- Antenatal diagnosis of fetal liver tumors is uncommon but crucial for management.
Observation:
- A complex, predominantly solid hepatic lesion (3x3 cm) with peripheral Doppler flow was detected on first obstetric ultrasound at 26 weeks gestation.
- Fetal echocardiography revealed vena cava displacement by the mass, with a normal fetal heart.
- Follow-up ultrasounds showed no change in the lesion size.
Findings:
- Postnatal MRI confirmed the diagnosis of hepatic hemangioma.
- The infant presented with visible thoracoabdominal circulation but no skin lesions.
- Treatment with prednisolone and interferon was initiated postnatally.
Implications:
- This case underscores the importance of routine obstetric ultrasound in detecting fetal anomalies.
- Antenatal diagnosis of hepatic hemangioma allows for proactive management strategies.
- Successful treatment outcomes demonstrate the efficacy of combined therapies for pediatric hepatic hemangioma.
Abstract:
Hepatic tumors in children account for only 1 to 5% of all pediatric tumors. Hepatic hemangioma is, however, the third most common tumor of the liver in childhood. We report a case of an antenatal diagnosis of a hepatic tumor detected on a first obstetric ultrasound, at 26(th) week of gestation. It revealed a complex, predominantly solid hepatic lesion with 3 x 3 cm and a marked, essentially peripheral, Doppler blood flow. Fetal echocardiography showed a normal heart besides a vena cava displacement by the hepatic mass. Fetal Hepatic hemangioma was suspected. Follow-up ultrasounds were unchanged. Pregnancy evolved well. At 36 weeks of gestation was spontaneously delivered a 3300 g boy whose examination revealed a visible thoracoabdominal circulation and a palpable liver. No skin lesions, namely hemangiomas or petechiae were identified. Postnatal magnetic resonance imaging confirmed the diagnosis of Hepatic hemangioma. Treatment was initiated with prednisolone followed by interferon. After 2 years, there is no active lesion.
