Mesenchymal hamartoma of the liver. A 35-year review
C. A. DeMaioribus, K. P. Lally, K. Sim, H. Isaacs and G. H. Mahour
Department of Surgery, Wilford Hall US Air Force Medical Center, Lackland Air Force Base, TX 78236.
Mesenchymal hamartoma of the liver occurs almost exclusively in infancy and
childhood, with approximately 140 total cases reported. We report the
experience with 18 patients at the Childrens Hospital of Los Angeles
(Calif) during the past 35 years. The charts of all patients with
mesenchymal hamartoma were retrospectively reviewed. The mean age at
presentation was 16 months. Thirteen patients were symptomatic, presenting
with increasing abdominal distention. Physical examination revealed an
abdominal mass or hepatomegaly. Ultrasonography and computed tomography
were the most useful diagnostic tests. Fourteen patients underwent
resection; 9 underwent hepatic resection and 5 underwent excision of the
tumor only. One patient had marsupialization, 1 underwent a biopsy only,
and 2 died of unrelated causes and the hamartoma was found incidentally at
autopsy. In all instances, a large cystic mass with well-demarcated margins
was found. Three patients were unavailable for follow-up and 13 patients
were alive and well 1 month to 24 years (mean, 5 years) after diagnosis.
Recurrence or malignant transformation was not noted. A presumptive
diagnosis can be made preoperatively by normal laboratory values and a
combination of ultrasonography and computed tomography. We recommend
excision of the tumor in all patients once the diagnosis is made, with the
expectation of complete recovery.
