Khan Muhammad Rehan, Binkovitz Larry A, Smyrk Thomas C, Potter D Dean, Furuya Katryn N
Division of Pediatric Gastroenterology & Hepatology, Department of Pediatrics, Mayo Clinic, Rochester, Minnesota, USA.
Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
Case Rep Pediatr. 2019 Sep 16;2019:4132842. doi: 10.1155/2019/4132842. eCollection 2019.
Mesenchymal hamartoma is a benign tumor of the liver with a poorly understood pathogenesis. It is uncommon in older children, especially after 2 years of age. The signs and symptoms may be nonspecific; therefore, a high index of suspicion is required for diagnosis and treatment. We report a 5-year-old previously healthy male who presented with acute abdominal pain, fatigue, and fever. He was diagnosed with pneumonia initially and treated with antibiotics. A computed tomography (CT) scan done for evaluation of his persistent abdominal pain demonstrated a hepatic mass. Follow-up magnetic resonance imaging (MRI) of the liver demonstrated multiple serpiginous tubular-type structures, read as possible Caroli syndrome. He had a normal abdominal examination and normal biochemistries including alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, and alpha-fetoprotein. He was referred to our institution for second opinion. On further review of his imaging studies, the lesion was thought to be a mesenchymal hamartoma. He subsequently underwent resection of the mass. Pathology confirmed the diagnosis of mesenchymal hamartoma.
间叶性错构瘤是一种肝脏良性肿瘤，其发病机制尚不清楚。在大龄儿童中并不常见，尤其是2岁以后。其体征和症状可能不具有特异性；因此，诊断和治疗需要高度的怀疑指数。我们报告一例5岁的既往健康男性，表现为急性腹痛、乏力和发热。他最初被诊断为肺炎并接受了抗生素治疗。为评估其持续性腹痛而进行的计算机断层扫描（CT）显示肝脏有一个肿块。肝脏的后续磁共振成像（MRI）显示多个匐行性管状结构，考虑可能为卡罗利综合征。他的腹部检查正常，包括丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转移酶、碱性磷酸酶和甲胎蛋白在内的生化指标也正常。他被转诊至我们机构寻求第二种意见。在进一步复查其影像学检查后，该病变被认为是间叶性错构瘤。他随后接受了肿块切除术。病理证实为间叶性错构瘤。
