Hepatoblastoma: radiologic-pathologic correlation in 50 cases

Fifty cases of hepatoblastoma were reviewed. Virtually all patients were infants or young children with hepatomegaly or a mass. Calcification seen on 11 of 20 radiographs was often in a pattern of small chunks, and eight of these correlated with osteoid formation in histologically mixed hepatoblastomas. Angiography generally showed tumor vascularity, sometimes with a spoke-wheel pattern. Suggestion of tumor nodularity or lobulation on sonography or computed tomography (CT) correlated with the gross appearance. The tumor was usually echogenic and occasionally had small hypoechoic or anechoic areas representing necrosis or hemorrhage. On CT it was usually hypodense, with minimal if any enhancement. The calcification pattern and demonstration of tumor lobulation with septation may help differentiate hepatoblastoma from other liver neoplasms in infants and children under 5 years of age.