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Hepatic Laceration with Active Bleeding
Joseph Junewick, MD FACR
over 7 years ago
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ARSt Case Repository

Infantile Hepatic Hemangioma

Case Detail

Anatomy: Gastrointestinal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 6 years ago
Updated: over 4 years ago
Tags: PEDS
Modality/Study Types: US CT
Activities:
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History

1 month old female with hepatomegaly.


Case Images


Diagnosis

Infantile Hepatic Hemangioma

Clinical Notes

Normal alpha-fetoprotein level for age.

Findings

US – Large multiseptated hepatic mass with marked peripheral hyperemia.

CT – Axial and coronal reformatted images confirm a large intrahepatic lesion with dense peripheral nodular enhancement; hypodensity centrally likely represents organizing hemorrhage or necrosis upon comparison to ultrasound.

Discussion

Most infantile hepatic hemangioma are diagnosed in the first 6 months of life; rarely they are discovered after 1 year of age. There is a slight increased incidence in females and patients with hemihypertrophy and Beckwith-Wiedemann syndrome. High flow infantile hepatic hemaniomas may present with CHF and/or coagulopathy. Low flow lesions may be asymptomatic or present as a mass. Other complications include rupture, hypothyroidism (secondary to tumor production of iodothyronine deiodinase), hyperbilirubinemia (secondary to RBC breakdown). On pathological analysis, hemangioma can be confirmed by positive immunoreactivity to erythrocyte-type glucose transporter protein-1.

Reference

Chung EM, Cube R, Lewis RB, et al. Pediatric Liver Masses: Radiologic-Pathologic Correlation Part 1. Benign Tumors. Radiographics (2010); 30: 801-826.



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