title: Mixed hepatoblastoma and teratoma of the liver in a 3-year-old child: a unique combination and clinical challenge.
abstract: Primary liver tumors in children are rare with malignant hepatoblastoma being the most common neoplasm. In this report, we describe the diagnosis and clinical management of a large liver tumor in a 3-year-old child that displayed the features of both, conventional hepatoblastoma and malignant teratoma. Pathological assessment on a pre-operative bioptical specimen showed an immature teratoid tumor with no area of hepatoblastic differentiation present. Histological and immunohistological examination of the resected tumor specimen additionally showed tumor areas of very different differentiation pattern intermixed with each other, namely areas of hepatoblastoma-typical and neuroblastoma-like morphology as well as areas of rhadomyosarcomatous differentiation.After chemotherapy the tumor size increased and an extended right hemihepatectomy was performed. Post-operatively, the general condition of the child improved and adjuvant chemotherapy was started two weeks later. 36 months after initial diagnosis the patient is healthy, in good general condition, and without any sign of residual tumor disease.Overall, we describe the diagnosis and clinical management of a large liver tumor in a 3-year-old child that displayed the features of both, conventional hepatoblastoma and malignant teratoma and was designated as mixed hepatoblastoma and teratoma. Though mesenchymal tumor portions can occur within hepatoblastomas, most commonly osteoid or chondroid, our case is different as it presents a large spectrum of mesenchymal and epithelial differentiation pattern in most of the lesion.
authors.affiliation: Institute of Pathology, University of Leipzig, Liebigstrasse 26, Leipzig, Germany. alex@praxismoll.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Moll
authors.forename: Alexander
authors.initials: A
authors.lastname: Krenauer
authors.forename: Uta
authors.initials: U
authors.lastname: Bierbach
authors.forename: Holger
authors.initials: H
authors.lastname: Till
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hirsch
authors.forename: Ivo
authors.initials: I
authors.lastname: Leuschner
authors.forename: Nicole
authors.initials: N
authors.lastname: Schmitz
authors.forename: Christian
authors.initials: C
authors.lastname: Wittekind
authors.forename: Thomas
authors.initials: T
authors.lastname: Aigner