PMC4802225_01
CT scan showing the encapsulated, loculated hepatic mass, 9 x 9 cm in the posterior segment of the right lobe, involving mainly segments V & VI, with inferomedial expansion.
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CT scan of the chest, abdomen and pelvis revealed an encapsulated, loculated hepatic mass, 9 x 9 cm in the posterior segment of the right lobe, involving mainly segments V & VI, with inferomedial expansion (Fig. 1).
Intraoperative picture taken, showing anatomical resection of segments V and VI.
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Patient was admitted, partial hepatectomy was performed: chevron incision, no peritoneal carcinomatosis, tumor identified in segments V & VI, cholecystectomy done, then bisegmentectomy done with Ultracision, removal of the specimen en-bloc, portocaval lymph nodes dissection performed (Fig. 2).
Upper half shows mesenchymal proliferation with large osteoid component and sheets of well-defined fetal type hepatocytes are seen in the right lower aspect of the field.
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Final pathology showed (Fig. 3): mixed epithelial-mesenchymal hepatoblastoma with predominance of fetal morphology in the epithelial component.
PMC4802225_02
Fetal hepatoblastoma featuring alternating pale and dark areas on the left side. Right side shows immature embryonal elements forming osteoid. Extramedullary hematopoiesis is also evident.
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These are associated with other smaller areas which are composed of embryonal type basophilic cells separated by areas of immature chondroid and osteoid tissue (Fig. 4).