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2012-05-18-09 Case of the week #324 ©Saadi www.TheFetus.net 


Answer to the case of the week # 324

August 2nd, 2012 - August 16th, 2012


Hanane Saadi1; Nissrine Mamouni1; Zineb Lakhssassi2; Majda Zakraoui3; Sanaa Errarhay1; Nadia Sqalli Houssaini3; Chahrazed Bouchikhi1; Siham.Tizniti3; Abdelhak Bouharrou2; Abdelaziz Banani1.

1 Department of gynecology-obstetric, University Hospital Hassan II, Fez 30 000, Morocco
2 Neonatal Intensive Care Unit, University Hospital Hassan II, Fez 30 000, Morocco
3 Department of radiology, University Hospital Hassan II, Fez 30000, Morocco
2

(Edited by F.G.)

Case report:

A 40-year-old woman (G5P2) was examined in our department at 36 weeks of her pregnancy. Her previous examinations were reported to be normal.

Our ultrasound examination found a fetus of overall normal biometry, except of abdominal circumference reaching 97th percentile. A hypoechoic round structure with hyperechoic center of 73 mm in its largest diameter was found in the right upper abdomen. Initially we considered the structure to be a mesoblastic nephroma, but magnetic resonance imaging was done later and enabled to localize the structure within hepatic parenchyma. This finding led us to the diagnosis of hepatic hemangioma (Click here to compare with case of the week # 201 and review of the hepatic tumor)

The male neonate was delivered at term (2700 g, Apgar score 7/10/10) and the postnatal ultrasonographic examination found hypervascular hepatic structure of inhomogeneous echogenicity.

Laboratory tests showed thrombocytopenia (80,000/mm3). During three months the hepatic mass has slowly decreased in size leaving just small hyperechoic region within the liver parenchyma. The laboratory tests have also got to normal levels.

Image 1: 36 weeks of gestational age: the image shows hypoechoic round structure with hyperechoic center of 73 mm in its largest diameter in the right upper right abdomen, representing hepatic hemangioma.



Images 2, 3, 4, and 5: CT images showing the mass of hemangioma within the fetal liver.





Images 6, 7: Image 6 represents postnatal ultrasonographic appearance of the liver with inhomogeneous mass of the hemangioma. The image 7 shows the hyperechoic appearance of the hepatic hemangioma three months after delivery.


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