Solid mesenchymal hamartoma in an adult: a case report

Abstract

Mesenchymal hamartoma of the liver (MHL) is an uncommon tumour composed of architecturally abnormal bile ducts in an uncommitted myxoid stroma. Most MHL are diagnosed in childhood and few cases have been reported in adults. This report describes a case of a well defined solid mass in the right lobe of the liver in a 51 year old man. Preoperative radiological examination revealed a large completely solid mass. Biopsy showed a dense fibrous stroma with hyalinisation and some bile ducts. A provisional diagnosis of MHL was made. Surgical excision was impossible and liver transplantation was undertaken. Definitive pathology confirmed the diagnosis. Review of published reports shows this to be the fourth case of MHL treated by liver transplantation.

Liver Transplantation for Benign Hepatic Tumors: A Systematic Review

“…Other rare indications for liver transplantation for benign hepatic tumors massively involving the liver and usually associated with other hepatic diseases were inflammatory pseudotumors, mesenchymal hamartoma, and focal nodular hyperplasia [46,47,48]. …”

Mesenchymal hamartoma of the liver imitating gastrointestinal stromal tumor

“…Z powodu ryzyka rozwoju mięsaków zarodkowych oraz wystąpienia powikłań, takich jak krwawienia do guza, niewydolność miąższu wątroby lub ucisk na struktury sąsiadujące, zalecanym postępowaniem w przypadku MHL jest resekcja chirurgiczna [12]. Rokowanie po wcześnie przeprowadzonym leczeniu operacyjnym jest pomyślne, natomiast w momencie rozwoju mięsaka -złe.…”

“…W przypadku guzów zbyt dużych, rozwoju powikłań lub u pacjentów obciążonych innymi schorzeniami zalecanym pierwszym etapem terapii jest embolizacja tętnicy wątrobowej. W przypadku MHL, których radykalna resekcja jest niemożliwa z powodu niekorzystnej lokalizacji anatomicznej, dopuszcza się przeprowadzenie transplantacji wątroby [12].…”

A young woman with a large mass in the right hepatic lobe

“…The majority of MHLs are cystic tumors, but some MHLs are solid. [3][4][5] Imaging findings on contrastenhanced computed tomography are absence of a tumor capsule and a weak heterogeneous enhancement in solid areas, which is nonspecific but different from liver adenomas and focal nodular hyperplasia 4 (Table 1). Thus, the clinical diagnosis of MHL is quite challenging, especially in adult patients ( Table 1).…”

“…3 The vast majority of MHLs are diagnosed before the first 5 years of life 3 and they are rarely seen in adults. MHL can sometimes even be recognized in utero.…”