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Mesenchymal Hamartoma With Elevated Alpha-Fetoprotein: A Diagnostic Pitfall
Amine Naggar1, Hajar Andour1, Hamza Bensaghir1
1Ibn Sina University Hospitals Center, Mohammed V University, Rabat, Morocco.
Abstract:
Mesenchymal hamartoma (MH) is a benign liver tumor accounting for 3% to 8% of all liver tumors in children, commonly manifesting before 3 years of life. Distinguishing MH from hepatoblastoma and other liver tumors relies on imaging and alpha-fetoprotein (which is usually within normal range in MH), before histologic examination. We report a case of a hepatic MH associated with elevated alpha-fetoprotein, leading to a misdiagnosis of hepatoblastoma and the administration of chemotherapy. We draw the attention to the diagnostic difficulty and pitfalls related to alpha-fetoprotein elevation in the setting of a liver tumor, and we highlight the importance of imaging and histology in establishing the diagnosis.
Insights
Mesenchymal hamartoma (MH), a benign liver tumor, can be misdiagnosed as hepatoblastoma if alpha-fetoprotein levels are elevated. This case highlights the importance of imaging and histology for accurate diagnosis in pediatric liver tumors.
Area of Science:
- Pediatric oncology
- Hepatobiliary pathology
Background:
- Mesenchymal hamartoma (MH) is a common benign pediatric liver tumor, typically presenting before age three.
- Accurate diagnosis of pediatric liver tumors is crucial for appropriate treatment and prognosis.
Observation:
- A case of hepatic MH presented with elevated alpha-fetoprotein (AFP), mimicking hepatoblastoma.
- This atypical presentation led to a misdiagnosis and unnecessary chemotherapy administration.
Findings:
- Elevated AFP levels in pediatric liver tumors can pose diagnostic challenges.
- Imaging and histological examination are critical for differentiating MH from malignant tumors like hepatoblastoma.
Implications:
- Clinicians should be aware of the potential for AFP elevation in MH to avoid misdiagnosis.
- Emphasizes the need for a comprehensive diagnostic approach, integrating imaging and histology, for pediatric liver masses.
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