Answer for BIR CoW 24 Aug 2025
INFANTILE HEPATIC HEMANGIOMA
Findings
Large well defined heterointense lesion with multiple internal flow voids in right lobe of liver. USG correlation, -Well defined large heteroechoic highly vascular lesion noted in the right lobe of liver which receives arterial supply from branches of the right hepatic artery and drains into hepatic veins. -Right hepatic artery and hepatic veins appears dilated. --Possibility of Infantile hepatic hemangioma
Discussion
Infantile hepatic hemangioma Liver lesions composed of large endothelial-lined vascular channels previously referred to as hepatic infantile hemangioendotheliomas Occurs in fetuses and neonates ( 16 weeks of GA to < 6 months of age ) Clinical features – hepatomegaly , congestive cardiac failure due to arteriovenous shunting Radiographic features Ultrasound - hypoechoic or hyperechoic or may display mixed echogenicity with prominent vascular channels On doppler - increased flow MRI - T1- hypointense T2- hyperintense Large flow voids
Treatment - infantile hepatic hemangiomas in infancy shows rapid, proliferative growth phase in the first six months of life, followed by regression and involution Asymptomatic – no treatment required Symptomatic (cardiac failure ) – propanalol, embolization
Differential diagnosis Hepatoblastoma , neuroblastoma metastasis, mesenchymal hamartoma
References
1.Chojniak R. The Diagnosis of Focal Liver Lesions in Pediatric Patients. Radiol Bras. 2020;53(3):IX-X. doi:10.1590/0100-3984.2020.53.3e3 – Pubmed
2.Wolfgang Dähnert. Radiology Review Manual. (2011) ISBN: 9781609139438 - Google Books
Findings
Large well defined heterointense lesion with multiple internal flow voids in right lobe of liver. USG correlation, -Well defined large heteroechoic highly vascular lesion noted in the right lobe of liver which receives arterial supply from branches of the right hepatic artery and drains into hepatic veins. -Right hepatic artery and hepatic veins appears dilated. --Possibility of Infantile hepatic hemangioma
Discussion
Infantile hepatic hemangioma Liver lesions composed of large endothelial-lined vascular channels previously referred to as hepatic infantile hemangioendotheliomas Occurs in fetuses and neonates ( 16 weeks of GA to < 6 months of age ) Clinical features – hepatomegaly , congestive cardiac failure due to arteriovenous shunting Radiographic features Ultrasound - hypoechoic or hyperechoic or may display mixed echogenicity with prominent vascular channels On doppler - increased flow MRI - T1- hypointense T2- hyperintense Large flow voids
Treatment - infantile hepatic hemangiomas in infancy shows rapid, proliferative growth phase in the first six months of life, followed by regression and involution Asymptomatic – no treatment required Symptomatic (cardiac failure ) – propanalol, embolization
Differential diagnosis Hepatoblastoma , neuroblastoma metastasis, mesenchymal hamartoma
References
1.Chojniak R. The Diagnosis of Focal Liver Lesions in Pediatric Patients. Radiol Bras. 2020;53(3):IX-X. doi:10.1590/0100-3984.2020.53.3e3 – Pubmed
2.Wolfgang Dähnert. Radiology Review Manual. (2011) ISBN: 9781609139438 - Google Books
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!