Neonatal hepatic malignant tumor. A correlative imaging approach

Area of Science:

• Pediatric Radiology
• Nuclear Medicine
• Pediatric Oncology

Background:

• Hepatomegaly in neonates necessitates thorough investigation to rule out conditions like biliary atresia.
• Hepatobiliary scintigraphy is a key diagnostic tool for evaluating neonatal liver function and biliary system patency.

Observation:

• A neonate presenting with hepatomegaly underwent hepatobiliary scintigraphy.
• Initial assessment aimed to exclude biliary atresia, a common cause of neonatal cholestasis.
• The imaging unexpectedly revealed extensive parenchymal lesions within the liver.

Findings:

• Biliary atresia was successfully ruled out in the neonate.
• Hepatobiliary scintigraphy demonstrated multiple, massive, non-biliary parenchymal lesions.
• Subsequent imaging modalities confirmed the lesions as multiple hepatoblastomas.

Implications:

• This case highlights the potential of hepatobiliary scintigraphy to incidentally detect non-biliary hepatic pathologies in neonates.
• The findings underscore the importance of considering rare diagnoses like hepatoblastoma in neonates with hepatomegaly, even when biliary atresia is suspected.
• This report represents the first documented instance of multiple hepatoblastomas discovered via hepatobiliary imaging in a pediatric patient.