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Cystic mesenchymal hamartoma

Case Detail

Anatomy: Gastrointestinal
Borders
Heather Borders, MD
Diagnostic Category: Neoplasia Benign
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: US
Activities:
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History

Newborn female with history of cystic mass on prenatal imaging. Possible bowel obstruction.


Case Images


Diagnosis

Cystic mesenchymal hamartoma

Findings

US demonstrates a large simple anechoic cyst in the left side of the abdomen of uncertain origin.

Discussion

An ovarian cyst should be considered for a large cyst in a female neonate. Other considerations include a mesenteric cyst, duplication cyst, renal cyst, dilated bowel or neoplasm. An ovarian cyst was suspected in this case. At surgery, this was found to be arising from the liver. Pathology was compatible with a cystic mesenchymal hamartoma.

Mesenchymal hamartoma presents in infancy or childhood, most commonly at 16 months of age. LFT’s usually remain normal.

Mesenchymal hamartoma is a benign neoplasm of the liver due to proliferation of mesenchymal or connective tissue. Typically composed of multiple cysts with variable stroma. The composition depends on the relative proportion of cystic and mesenchyal tissue. When intrahepatic, the diagnosis is easier. In this case, the lesion was pedunculated and was also unilocular rather than multiseptated.

Pathologically, multiple cysts with clear or mucoid material are identified. Microscopic pathology demonstrates loose mesenchymal tissue with bile ducts, hepatocytes and blood vessels.

Surgical resection is definitive.

Reference

Statdx. Mesenchymal hamartoma.



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