Gradually enlarging abdominal swelling and failure to thrive.
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CT scout image reveals a large gasless area at the left hypochondrial and lumbar regions. CT shows a large mass arising from the left hepatic lobe which displaces the stomach and adjacent bowel. The lesion shows mild enhancement with contrast with extensive areas of internal necrosis. No calcification.
Diagnosis: Hepatoblastoma epithelial type (pathology proved)
Hepatoblastoma is the commonest primary malignant tumor of the liver. It is more common in males and associated with other syndromes e.g. hemihypertrophy, Beckweth Weidemann and familial polyposis. Calcification presents in 50% of the tumor mostly of mixed type. Epithelial type usually lacks calcification. Differential diagnosis includes; intantile hemangioendotheliosis, mesenchymal hamartoma and neuroblastoma metastasis.