Answer to Quiz No. 79 dated 11 September 2016

Mesenchymal hamartoma


Findings
A large heterogenous lesion with multiple cystic areas and intervening septations is seen in the right lobe of liver . no calcifications are seen. no hypervascularity seen. mild enhancement is seen on post contrast study.
Discussion
Mesenchymal hamartoma is a cystic hepatic tumor that is the second most common benign hepatic liver mass in the pediatric population. Usually detected in patients under the age of 2 years, mesenchymal hamartoma occurs twice as often in boys than in girls. Affected pediatric patients typically present with an enlarging abdominal mass but are otherwise asymptomatic. As the mass enlarges, patients may develop vomiting, diarrhea, or constipation. A resultant mass effect on the diaphragm may cause respiratory distress. On ultrasound, mesenchymal hamartoma presents as a multiseptated cystic mass with little or no internal vascularity . On CT and MRI, there is a multiseptated mass of water attenuation and signal intensity, respectively The thin internal septations may show contrast enhancement. Mesenchymal hamartoma most commonly involves the right hepatic lobe and is not typically associated with calcification or hemorrhage


​References
Focal Hepatic Masses in Pediatric Patients Adebunmi O. Adeyiga, Edward Y. Lee, and Ronald L. Eisenberg American Journal of Roentgenology 2012 199:4, W422-W440