(CR 27) Hepatic Mesenchymal Hamartoma- A Rare Benign Developmental Tumour

Introduction: Hepatic mesenchymal hamartoma (HMH) is a rare benign pediatric hepatic tumor that derives frommesenchymal tissue. It is of uncertain etiology with majority of cases in less than 2 years of age. Thediagnosis is a challenge with its non-specific clinical symptoms and lack of definitive laboratory studies; hence, radiological imaging is crucial for diagnosis. Case Presentation: We report a case study of a 2-year-old boy presented with abdominal distension for 2 months, gradually increasing in size. A right sided intra-abdominal mass was palpable with sonographic correlation of a large multicystic lesion in the right hypochondrium. Hematological and biochemical investigations were within normal limits. Alpha-fetoprotein and B-HCG values were unremarkable. Contrast enhanced CT showed a large multiseptated cystic mass measuring 12.3cm x 12.7cm x 15.6cm in right liver lobe. Patient was planned for laparotomy and extended right hepatectomy with intra-operative findings of a large cystic mass occupying the right liver lobe weighing 1240 grams. A histological diagnosis of HMH was made based on distinctive morphological features. The patient recovered well post-operatively and was discharged home. Conclusion: HMH is a benign childhood tumour with mean age of presentation of 20 months. Mesenchymalhamartomas originate from a congenital localized abnormality in ductal plate development. The diagnosis of these tumors are often delayed with diagnostic precision relying on radiological characterization and histological evaluation of the tissue. Radical surgical excision is the gold standard treatment option toprevent cases of local recurrence and possible malignant transformation.