Mesenchymal hamartoma of the liver in adults: Case report

Tz, Lakić; Mm, Živojinov; Vuković, Miloš; Sabo, Ilić; Boskovic, Tatjana

doi:10.2298/mpns1412399l

Med pregl

2014

DOI: 10.2298/mpns1412399l

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Mesenchymal hamartoma of the liver in adults: Case report

Lakić Tz

Živojinov Mm

Miloš Vuković

et al.

Abstract: Mesenchymal hamartoma of the liver is a benign tumor resulting from abnormal, intra-uterine development of bile ducts and has a delayed clinical manifestation, thus this lesion appears to be related to the processes of maturation. It is potentially pre-malignant lesion presenting as a solid and/or cystic neoplasm. Symptoms, laboratory results and radiographic imaging are nonspecific and inconclusive, so surgical excision of the whole lesion is the imperative for the definitive diagnosis.

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Liver transplantation for a giant mesenchymal hamartoma of the liver in an adult: Case report and review of the literature

Cai

Guo

et al. 2015

WJG

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Mesenchymal hamartomas of the liver (MHLs) in adults are rare and potentially premalignant lesions, which present as solid/cystic neoplasms. We report a rare case of orthotopic liver transplantation in a patient with a giant MHL. In 2013, a 34-year-old female sought medical advice after a 2-year history of progressive abdominal distention and respiratory distress. Physical examination revealed an extensive mass in the abdomen. Computed tomography (CT) of her abdomen revealed multiple liver cysts, with the diameter of largest cyst being 16 cm × 14 cm. The liver hilar structures were not clearly displayed. The adjacent organs were compressed and displaced. Initial laboratory tests, including biochemical investigations and coagulation profile, were unremarkable. Tumor markers, including levels of AFP, CEA and CA19-9, were within the normal ranges. The patient underwent orthotopic liver transplantation in November 2013, the liver being procured from a 40-year-old man after cardiac death following traumatic brain injury. Warm ischemic time was 7.5 min and cold ischemic time was 3 h. The recipient underwent classical orthotopic liver transplantation. The recipient operative procedure took 8.5 h, the anhepatic phase lasting for 1 h without the use of venovenous bypass. The immunosuppressive regimen included intraoperative induction with basiliximab and high-dose methylprednisolone, and postoperative maintenance with tacrolimus, mycophenolate mofetil, and prednisone. The recipient's diseased liver weighed 21 kg (dry weight) and measured 41 cm × 32 cm × 31 cm. Histopathological examination confirmed the diagnosis of an MHL. The patient did not experience any acute rejection episode or other complication. All the laboratory tests returned to normal within one month after surgery. Three months after transplantation, the immunosuppressive therapy was reduced to tacrolimus monotherapy, and the T-tube was removed after cholangiography showed no abnormalities. Twelve months after transplantation, the patient remains well and is fulfilling all normal activities. Adult giant MHL is extremely rare. Symptoms, physical signs, laboratory results, and radiographic imaging are nonspecific and inconclusive. Surgical excision of the lesion is imperative to make a definite diagnosis and as a cure. Liver transplantation should be considered as an option in the treatment of a non-resectable MHL.

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Liver transplantation for a giant mesenchymal hamartoma of the liver in an adult: Case report and review of the literature

Cai

Guo

et al. 2015

WJG

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Mesenchymal hamartoma of the liver in adults: Case report

Cited by 1 publication

References 8 publications

Liver transplantation for a giant mesenchymal hamartoma of the liver in an adult: Case report and review of the literature

Liver transplantation for a giant mesenchymal hamartoma of the liver in an adult: Case report and review of the literature

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