PMC4818299_01
RMN imaging: typical radiological aspect of a liver metastasis. No other localizations are evident in the RMN.
gr1.jpg
PMC4818299_01_gr1.jpg
fig0005
In October 2013, new MRI revealed an increased liver metastases up to 5 cm (Fig. 1).
Exophitic lesion of the II segment with diaphragm infiltration.
gr2.jpg
PMC4818299_01_gr2.jpg
fig0010
Peritoneal exploration revealed a large solid lesion of the second liver segment, completely exophytic, with diaphragm infiltration (Fig. 2).
Pericardial nodule. The Harrington retractor holds the heart to permit the exposure of the inferior cava vein.
gr3.jpg
PMC4818299_01_gr3.jpg
fig0015
During the surgery, through the diaphragmatic defect, a pericardial nodule of about 4 cm was discovered along the infero-lateral cardiac margin (Fig. 3).
Bovine pericardium patch to repair diaphragm defect.
gr4.jpg
PMC4818299_01_gr4.jpg
fig0020
The defect of the diaphragm was repaired using a 10 x 10 cm of bovine pericardium (Fig. 4), sutured with Ethylene Terephthalate.
(A, B) Hematoxylin eosin of the liver tumor; (C, D) anti-hepatocitic antigen and alphaphetoprotein positivity respectively of the liver tumor; (E, F) hematoxylin eosin pericardial metastasis.
gr5.jpg
PMC4818299_01_gr5.jpg
fig0025
Final diagnosis was adult hepatoblastoma with pericardial metastasis (Fig. 5).