Management of Fetal Mesenchymal Hamartoma of the Liver: A Case Report

Introduction : Hepatic mesenchymal hamartomas are rare benign tumours of the liver. Although most cases are discovered after birth, a few antenatal diagnoses have been reported in the literature. Case presentation: This is an 8-month-old girl with a prenatal diagnosis of a non-vascular anechogenic intra-abdominal mass, 30 mm in size, without septum, discovered during the third-trimester ultrasound. She was born at term by caesarean section due to macrosomia and gestational diabetes. No palpable mass on clinical examination was found. Abdominal ultrasound revealed the presence of a cystic mass in anterior of the left hepatic lobe with transsonic content, without clean wall or tissue component, with cloisons, some of which are thickened, measuring 79*40*70mm. A CT scan showed an exophytic cystic mass of the left liver in segments 2, 3 and 4. It measured 83*37*84 mm. It was next to the liver's left portal branch and away from the hepatic veins. On a clinical X-ray, the left liver's mesenchymatous hamartoma appears. Tumour markers were negative. The patient underwent surgery at 8-month-old via a right subcutaneous incision and was found to have a thin-walled cystic mass. This mass was exophytic in relation with segments II and III, measuring 8cm with a cleavage plane, and the entire mass was resected. Conclusion: Mesenchymal hamartoma is a rare benign pathology that can be diagnosed antenatally. Complete resection is the recommended therapeutic approach, with a favorable outcome.