Neonatal Mesenchymal Hamartoma of Liver: An Unusual Presentation
A 2-week-old boy, one of twins, presented with huge progressive abdomen distention, non bilious vomiting, and respiratory distress since birth. Antenatal ultrasound scan at the 5th month showed diamniotic dichorionic twin fetus. Abdominal examination revealed nontender, cystic mass occupying almost the whole of abdomen. Blood chemistry of serum electrolytes, coagulation screen and liver function tests were normal. Plain X-ray abdomen showed soft tissue homogenous opacity occupying the entire abdomen with displacement of bowel to left upper quadrant []. Ultrasound of abdomen revealed uniloculated, huge midline anechoic lesion extending on either side with clear fluid and of uncertain origin []. Neonate developed severe respiratory distress due to progressive abdominal distention. Hence he was posted for emergency laparatomy and 2000 ml of clear fluid was aspirated from the cyst. The cyst was found to be uniloculated peduncle swelling arising from the inferior surface of right lobe of liver [] and did not have any biliary communication. It was excised in toto. The cyst had displaced the malrotated bowel. Histopathology confirmed uniloculated cystic structure with wall containing proliferating bile ductules, lymphocytic infiltration, compressed hepatic cords, nodules, and no distinct lining suggestive of MHL []. Postoperative recovery was uneventful and at 1 year follow-up the child is thriving well.