Massive, solitary, intrahepatic, extramedullary hematopoietic tumor in thalassemia

Diffuse compensatory extramedullary hematopoiesis is well known to involve the spleen and liver in certain hematologic disorders. Hematopoietic tumor masses occasionally form and usually occur paraspinally in the posterior mediastinum. A 31-year-old patient with thalassemia is described with a massive, solitary, intrahepatic hematopoietic tumor and a smaller one in the posterior mediastinum. Review of the literature indicates that presentation as a large, focal liver lesion is unique. The implications and differential diagnosis are discussed.