Pure fetal hepatoblastoma in a young female

A 22-year-old woman noted a fist-sized mass on her upper abdomen 1 month previously. She had occasional fever. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) revealed a huge lesion in the left lobe and intrahepatic metastasis (Panels A,B). Positron emission tomography (PET)-CT showed a mixed density mass (9.5 cm × 8.0 cm) in the left liver lobe with a SUVmax =4.51 (Panel C). Serum CEA, CA 19-9 and CA15-3 were normal. Serum alpha-fetoprotein (AFP) was 53.52 ng/mL. With the clinical suspicion of a hepatic malignancy, we realize a left hepatectomy, caudate lobectomy and microwave ablation of the tumors, that shows a mixed mass with areas of hemorrhage or necrosis (Panels D,E). A H&E staining revealed the tumor cells showed thin plates or nests of small-to-medium-sized uncrowded cells resembling hepatocytes of the developing fetal liver (Panel F, 20×). Immunohistochemistry findings were as follows: CK, (+−); Vimentin (−); AFP, (+−); CD 34, (+); CgA, (−); Hepatocytes, (+); and Ki-67, (10%+). We diagnosed the tumor as a pure fetal hepatoblastoma.

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Conflicts of Interest: The authors have no conflicts of interest to declare.

Informed Consent: Written informed consent was obtained from the patient for publication of this manuscript and any accompanying images.