Co-existing infantile hepatic hemangioma and mesenchymal hamartoma in a neonate

Area of Science:

• Pediatric Oncology
• Hepatology
• Surgical Pathology

Background:

• Infantile hepatic hemangioma (IHH) and mesenchymal hamartoma (MH) are the most common pediatric liver tumors.
• Early diagnosis and management are crucial for favorable outcomes in affected newborns.

Observation:

• A newborn presented with a rapidly growing liver mass, anemia, respiratory, and renal failure.
• Imaging revealed multifocal cystic and solid liver lesions with arterial enhancement.
• Elevated alpha-fetoprotein levels were noted in the absence of cardiac or cutaneous signs.

Findings:

• Pathological analysis confirmed synchronous IHH (GLUT-1 positive) and MH.
• Initial non-anatomical liver resection was followed by further surgical interventions for persistent lesions.
• Combined surgical and medical treatment (beta-blockers) led to lesion resolution.

Implications:

• This case highlights the importance of prompt diagnosis and multidisciplinary management for complex pediatric liver tumors.
• The successful use of beta-blockers suggests a potential role in managing refractory or complex cases of IHH and MH.
• Synchronous occurrence of IHH and MH, though rare, requires careful consideration in the differential diagnosis of neonatal liver masses.