Unusual mesenchymal hamartoma with uncommon biliary anatomy: Case report and literature review

We report a case of a mesenchymal hamartoma of the liver in a twenty-month-old girl. The patient initially consulted her pediatrician, and was then referred to the emergency room for evaluation of a palpable upper midline abdominal mass. The initial referral questioned splenomegaly. Radiologic workup consisted of an abdominal ultrasound, followed by a magnetic resonance imaging ( MRI) which showed a left hepatic lobe mass measuring 10 x 7 x 12 cm. The patient eventually underwent a left hepatectomy for excision of the mass. Postoperative course was complicated by a biliary leak secondary to an anatomic variant. The goal of this case report is to review the main features of liver hamartomas, and to discuss the possible anatomical variants of the biliary system that can be encountered in children. (C) 2014 The Authors. Published by Elsevier Inc.