Ya Jin1,2, Lin Li3, Fan Yang1,2,4. 1. Department of Ultrasound. 2. Key Laboratory of Obstetrics and Gynecology and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital of Sichuan University. 3. Department of Pathology, West China Hospital of Sichuan University. 4. Chengdu Chenghua District Maternal and Child Health Hospital, Chengdu, Sichuan, China.
Abstract
RATIONALE: The drastic differences in treatment and prognosis of infantile hepatic hemangioma (IHH) and hepatoblastoma (HBL) make accurate prenatal diagnosis imperative. The retrospective comparisons of ultrasonic features between fetal IHH and HBL have been reported before, but clinically, the differential diagnosis in utero is very difficult and can lead to prenatal misdiagnosis. PATIENT CONCERNS: A 27-year-old woman at 30 gestational weeks underwent the routine prenatal examination. A heterogeneous solid mass of the fetus, with close relationship to the liver, was recognized by ultrasound. DIAGNOSIS: A diagnosis of HBL was highly considered. INTERVENTIONS: The fetus was aborted and the autopsy was performed. OUTCOMES: The histological outcome was IHH. LESSONS: The prognosis of fetal IHH and HBL is very different, so an accurate diagnosis prenatally is crucial and indispensable. The radiologist and clinician should differentiate between IHH and HBL, especially since the fetus can have serious complications.
RATIONALE: The drastic differences in treatment and prognosis of infantile hepatic hemangioma (IHH) and hepatoblastoma (HBL) make accurate prenatal diagnosis imperative. The retrospective comparisons of ultrasonic features between fetal IHH and HBL have been reported before, but clinically, the differential diagnosis in utero is very difficult and can lead to prenatal misdiagnosis. PATIENT CONCERNS: A 27-year-old woman at 30 gestational weeks underwent the routine prenatal examination. A heterogeneous solid mass of the fetus, with close relationship to the liver, was recognized by ultrasound. DIAGNOSIS: A diagnosis of HBL was highly considered. INTERVENTIONS: The fetus was aborted and the autopsy was performed. OUTCOMES: The histological outcome was IHH. LESSONS: The prognosis of fetal IHH and HBL is very different, so an accurate diagnosis prenatally is crucial and indispensable. The radiologist and clinician should differentiate between IHH and HBL, especially since the fetus can have serious complications.
Authors: Israel N Kochin; Tamir A Miloh; Ronen Arnon; Kishore R Iyer; Frederick J Suchy; Nanda Kerkar Journal: Isr Med Assoc J Date: 2011-09 Impact factor: 0.892