title: Right adrenal gland neuroblastoma infiltrating the liver and mimicking mesenchymal hamartoma: A case report.
abstract: BACKGROUND
  Neuroblastoma is the most common extracranial solid pediatric malignancy. The most common site is abdomen with predominance of suprarenal medulla. Infiltration of the tumour to the liver is rare. No cases were reported in the literature about the misdiagnosis of neuroblastoma as mesenchymal hamartoma in the liver.
  
  
  METHODS
  We represent a rare case of neuroblastoma misdiagnosed as mesenchymal hamartoma in liver in a six-month-old female infant presented with fever and abdominal mass. Abdominal computed tomography (CT) revealed large cystic lesion occupying most of the right liver enchroaching upon right suprarenal region and displacing the right kidney inferior suggestive for mesenchymal hamartoma. Right adrenalectomy with en-bloc resection of the adjacent liver segments was done. Postoperative pathology revealed neuroblastoma with positive specific immunohistochemistry (IHC).
  
  
  CONCLUSIONS
  Although neuroblastoma is the second most common pediatric abdominal malignancy with specific diagnostic modalities, a misdiagnosis of a case with neuroblastoma as mesenchymal hamartoma is rare. Histopathological diagnosis of neuroblastoma with positive IHC is essential as shown in our case.
  
  
  CONCLUSIONS
  We represent a rare case of neuroblastoma which arose from the right adrenal gland and infiltrated the adjacent liver substance mimicking mesenchymal hamartoma of the liver. Neuroblastoma is rarely presented with pyrexia of unknown origin. Neuroblastoma should be considered in differential diagnosis of abdominal mass in all infants and children.
authors.affiliation: Professor of Gastrointestinal Surgery, Gastroenterology Surgical Center (GEC), Department of Surgery, Mansoura University, Egypt. Electronic address: passage_light@yahoo.com.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abo-Elenain
authors.affiliation: Gastroenterology Surgical Center (GEC), Department of Surgery, Mansoura University, Egypt. Electronic address: midnight_surgeon@hotmail.com.
authors.forename: Yousif
authors.initials: Y
authors.lastname: Naiem
authors.affiliation: Gastroenterology Surgical Center (GEC), Department of Surgery, Mansoura University, Egypt.
authors.forename: Hosam
authors.initials: H
authors.lastname: Hamedhosam-Eldin Hotmail Com
authors.affiliation: Gastroenterology Surgical Center (GEC), Department of Surgery, Mansoura University, Egypt. Electronic address: Dr_mido_emam@yahoo.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Emam
authors.affiliation: Pathology Department, Mansoura University, Egypt. Electronic address: wagdi.elkashef@gmail.com.
authors.forename: Wagdi
authors.initials: W
authors.lastname: Elkashef
authors.affiliation: Gastroenterology Surgical Center (GEC), Department of Surgery, Mansoura University, Egypt. Electronic address: dr_ahmadabdelrafee@yahoo.com.
authors.forename: Ahmed
authors.initials: A
authors.lastname: AbdelRafee