PMC10373925_01
(A) Prenatal ultrasound findings at 28 weeks gestation showed a large, cystic and solid mass (3.6 x 3.6 x 3.0 cm) in the left lobe of the liver. (B) Postpartum hepatic ultrasonography showed a 5.3 x 4.7 x 3.3 cm mass with abundant blood signal. (C)The diameter of the left hepatic vein was dilated (0.8 cm). (D) Enhanced CT revealed a large arteriovenous fistula in the left hepatic lobe.
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F1
An ultrasound taken at 28 weeks of gestation revealed the hepatic space-occupying lesion to be 3.6 cm x 3.6 cm x 3.0 cm (Figure 1A). Postpartum hepatic ultrasonographic examination showed a 5.3 cm x 4.7 cm x 3.3 cm mass with abundant blood signal (Figure 1B). Furthermore, there was an increase in the diameter of both the left hepatic vein (0.8 cm) and the hepatic artery (0.4 cm) (Figure 1C). Contrast CT of the abdominal microvasculature demonstrated that the abnormal blood vessels originated from the hepatic artery and drained into the inferior vena cava through the branches of the middle and left hepatic veins (Figure 1D).
(A) The hepatic angiography showed arteriovenous fistulas. (B) The fistulas reduction after embolization.
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F2
Moreover, the right hepatic artery connecting with the portal vein formed the artery-portal vein fistula (Figure 2A). To treat the fistulas, we inserted three spring coils to embolize the hepatic artery branch (Figure 2B).
(A) Brain MRI demonstrated multiple intracranial tumors. (B) The pathology revealed an epithelial-type hepatoblastoma.
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F3
MRI scan revealed multiple intracranial tumors (Figure 3A). Meanwhile, the pathology of the resected hepatic lobe revealed an epithelial-type hepatoblastoma (mixed fetal and embryonal) (Figure 3B).