Infantile hepatic hemangioma

Case contributed by Rade Kovač
Diagnosis certain

Presentation

Abdominal distension.

Patient Data

Age: 4.5 months
Gender: Female
This study is a stack
Axial
non-contrast
This study is a stack
Axial C+
arterial phase
This study is a stack
Axial C+ portal
venous phase
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Info

An extensive intra-abdominal mass lesions, which diffusely infiltrate the liver, appearing as multiple hypodense areas in comparison to liver parenchyma. They show peripheral postcontrast enhancement on arterial and gradual filling in on venous phase.

IVC can't be visualized.

Retroperitoneum can't be differentiated from the lesion.

Kidneys and spleen are displaced posteriorly.

mri
This study is a stack
Coronal
T2
This study is a stack
Axial T2
fat sat
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Axial T1
out-of-phase
This study is a stack
Axial T1
in-phase
This study is a stack
Coronal T1
out-of-phase
This study is a stack
Coronal T1
in-phase
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Info

Multiple well-defined spherical masses involving the liver, mostly the left lobe, T1 hypointense and T2 hyperintense relative to the liver, which cause extensive liver enlargement.

Flow voids can be seen in or adjacent to some lesions.

Case Discussion

Histopathology report confirmed infantile hepatic hemangioma.

This case shows near-total replacement of the hepatic parenchyma with many lesions, which caused high-output heart failure due to arteriovenous and portovenous shunting. The patient was treated with propranolol and corticosteroids.

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