Mesenchymal hamartoma of the liver identified by fetal sonography

Foucar, Elliott; Williamson, R A; Yiu-Chiu, Victoria S.; Varner, M.W.; Kay, BR

doi:10.2214/ajr.140.5.970

Cited by 35 publications

(22 citation statements)

References 8 publications

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“…Cystic placental changes similar to those seen in our patient were reported in association with MHL [3,10,12]. In one case, the abnormal placenta was noted at 16 weeks of gestation while the cystic liver mass became apparent only at 34 weeks; postnatally, the child did well and placental pathology showed MSVHP [12].…”

Section: Discussionsupporting

confidence: 81%

“…One was stillborn at 26 weeks of gestation after induced labor, one was associated with fetal demise at 36 weeks and one resulted in neonatal death (table 1) [3][4][5][6][7][8][9][10][11][12][13]. Our report appears to be the first where diagnosis of MHL was made in the second trimester and where fetal demise occurred as early as 24 weeks of gestation.…”

Section: Discussionmentioning

confidence: 71%

“…It usually presents as an asymptomatic abdominal mass in infancy and prognosis is good after resection [1][2][3]. Diagnosis of this lesion in utero may be associated with a poorer prognosis and may require fetal intervention.…”

confidence: 99%

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Large Hepatic Mesenchymal Hamartoma Leading to Mid-Trimester Fetal Demise

et al. 2005

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This report describes a fetus with a large multiloculated cystic liver mass. Two small abdominal cysts were seen on ultrasound at 19 weeks of gestation but the patient was referred to us at 23 weeks, after the mass had grown to 8.0 × 5.6 × 7.0 cm, displacing intra-abdominal organs, heart and diaphragm. There was a small amount of ascites but no hydrops. There was polyhydramnios and a thick hyperechoic placenta. After detailed sonograms and MRI suggested the diagnosis of cystic mesenchymal hamartoma of the liver, cyst decompression was favored and consent was obtained. Unfortunately, absence of fetal cardiac activity was noted on the day of the planned intervention. Autopsy confirmed the diagnosis and demonstrated placental changes consistent with mesenchymal stem villous hyperplasia of the placenta. Large fetal cystic abdominal masses that compress the heart, lungs and other organs may benefit from prenatal decompression. This is the first report of cystic hamartoma of the liver apparent on second-trimester sonography, and the fourth time such a lesion is associated with fetal or neonatal death out of 11 cases diagnosed prenatally.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 71%

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Large Hepatic Mesenchymal Hamartoma Leading to Mid-Trimester Fetal Demise

et al. 2005

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“…However, the cystic placental lesion diminished during the rest of the pregnancy, and the report did not mention any additional details on the pathological findings. Foucar commented on a markedly thickened placenta that weighed 1,510 g at 34 weeks, with prominent dilatation of placental vessels with thrombosis [8]. These cases could have had a similar association if a detailed examination of the placenta had been performed.…”

Section: Discussionmentioning

confidence: 99%

Hepatic Mesenchymal Hamartoma Associated with Mesenchymal Stem Villous Hyperplasia of the Placenta

Ruchelli¹,

Weiner²,

Ns³

2000

Fetal Diagn Ther

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A rare case of prenatally diagnosed hepatic mesenchymal hamartoma associated with mesenchymal stem villous hyperplasia of the placenta is presented and the literature reviewed. The placenta was noticed to have multiple cysts at 16 weeks’ gestation and elevated maternal serum α-fetoprotein was present. Cystic liver masses were first detected in the fetus at 34 weeks’ gestation. The liver mass showed a progressive enlargement during the third trimester and after birth, necessitating extended left hepatic trisegmentectomy at 3 months of age. Histological examination established the diagnosis of mesenchymal hamartoma of the liver and mesenchymal stem villous hyperplasia of the placenta. This is the first report of this association in which both lesions were diagnosed in utero and confirmed by histology after delivery. The likely pathogenesis of these strikingly similar lesions is discussed.

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“…HMH has also been associated with placental abnormalities as mesenchymal stem villous hyperplasia of the placenta (MSVHP), thrombosis, or transient honeycombed multicystic placental enlargement [8,9,12,14,15,20] . It is not clear whether HMH and these placental abnormalities both occur as an abnormal development of the mesoderm, the hepatic lesions are secondary to the placental changes or whether the MSVHP results from umbilical vein obstruction by the HMH [8,9] .…”

Section: Discussionmentioning

confidence: 99%

Mesenchymal Hamartoma of the Liver: A Benign Tumor with Deceptive Prognosis in the Perinatal Period

Cornette¹,

Festen

Hoonaard

et al. 2009

Fetal Diagn Ther

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This article reports a case of perinatal mesenchymal hepatic hamartoma and reviews the literature on the subject. A fetus presented with polyhydramnios and a large multiloculated cystic abdominal mass at 33 weeks of gestation. The ultrasound appearance was most consistent with a mesenteric cyst. Prenatal drainage was considered, due to the size of the lesion. However, a conservative management was opted for. A female infant was born at 35 weeks by classical cesarean section. The immediate postnatal period was characterized by hemodynamic instability. Laparotomy revealed a pedunculated mesenchymal hamartoma of the liver, which could not completely be resected. The infant had an uneventful postoperative recovery and is doing well at 6 months of age. Hepatic mesenchymal hamartoma are rare benign tumors. Most cases are detected in early childhood. They usually present as a cystic rapidly growing abdominal mass. Prenatal diagnosis remains challenging. In children diagnosed in the perinatal period, the outcome seems worse and determined by the compressive effect of the mass.

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Mesenchymal hamartoma of the liver identified by fetal sonography

Cited by 35 publications

References 8 publications

Large Hepatic Mesenchymal Hamartoma Leading to Mid-Trimester Fetal Demise

Large Hepatic Mesenchymal Hamartoma Leading to Mid-Trimester Fetal Demise

Hepatic Mesenchymal Hamartoma Associated with Mesenchymal Stem Villous Hyperplasia of the Placenta

Mesenchymal Hamartoma of the Liver: A Benign Tumor with Deceptive Prognosis in the Perinatal Period

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