28767567 Visualization

A 4 Age and Age a Age half Age years Age old Age male Sex child presented Clinical_event to our hospital Nonbiological_location for abdominal Biological_structure swelling Sign_symptom .
The child occasionally Detailed_description felt stomach Sign_symptom ache Sign_symptom that was relieved Detailed_description for Detailed_description no Detailed_description reason Detailed_description .
The child showed no obvious tenderness Sign_symptom and rebound Sign_symptom .
He was born History as History a History premature History baby History in History the History 32nd History week History of History his History mother's History pregnancy History .
His medical history included inguinal History hernia History on History 2 History sides History , but he had only received an operation History for History the History left History inguinal History hernia History .
No Family_history family Family_history or Family_history genetic Family_history history Family_history was Family_history found Family_history .
Physical Diagnostic_procedure examination Diagnostic_procedure of this child showed that the abdomen Biological_structure was obviously Detailed_description bulging Sign_symptom .
The mass Sign_symptom could be touched below Biological_structure umbilicus Biological_structure about Distance 3 Distance fingers Distance .
There were no other positive signs.
The results of laboratory Diagnostic_procedure tests Diagnostic_procedure were almost Lab_value normal Lab_value , including alpha Diagnostic_procedure - fetoprotein Diagnostic_procedure ( AFP Diagnostic_procedure ) level.
The Child Diagnostic_procedure – Pugh Diagnostic_procedure score Diagnostic_procedure was less Lab_value than Lab_value 5 Lab_value .
Abdominal Biological_structure ultrasonography Diagnostic_procedure showed an uneven Detailed_description lesion Sign_symptom in the liver Biological_structure and a diagnosis of HB Disease_disorder was considered.
Enhancement Detailed_description computed Diagnostic_procedure tomography Diagnostic_procedure ( CT Diagnostic_procedure ) scanning showed a large Detailed_description mass Sign_symptom in the left Biological_structure upper Biological_structure abdomen Biological_structure and left Biological_structure lobe Biological_structure of Biological_structure the Biological_structure liver Biological_structure with an irregular Shape edge Shape .
The size of the mass Coreference was 12.3 Volume   × Volume   10.2 Volume   × Volume   7.2 Volume   cm Volume (Fig.1).
There was an uneven Detailed_description nodular Detailed_description shadow Detailed_description and the edge Detailed_description was Detailed_description obvious Detailed_description when the mass Coreference was enhanced.
Calcification Sign_symptom and an expanded Sign_symptom bile Sign_symptom duct Sign_symptom were not observed.
The left Biological_structure branch Biological_structure of Biological_structure the Biological_structure portal Biological_structure was pressed Detailed_description and the distant Detailed_description part Detailed_description was Detailed_description shown Detailed_description to Detailed_description be Detailed_description unclear Detailed_description .
Abnormal Sign_symptom was not observed in the right Biological_structure branch Biological_structure .
According to the medical history, the diagnosis of HB Disease_disorder was considered.
We did not recommend a biopsy Diagnostic_procedure to the patient because it might cause bleeding and tumor diffusion.
An operation Therapeutic_procedure was necessary.
The patient underwent DVSS Therapeutic_procedure surgery Therapeutic_procedure with Detailed_description sufficient Detailed_description preparation Detailed_description .
Exploration Diagnostic_procedure showed an extrahepatic Detailed_description 12 Area   × Area   10 Area   cm Area mass Sign_symptom in the left Biological_structure lobe Biological_structure of Biological_structure the Biological_structure liver Biological_structure (Fig.2).
After the operation, the sample Coreference was split Detailed_description .
The edge Shape of the tumor Coreference was clear Shape but no Detailed_description envelope Detailed_description .
Tremelloid Detailed_description mesenchyme Biological_structure was seen on the section (Fig.2C).
The pathological examination showed that the sample Coreference was grey Color red Color and 14 Volume   × Volume   13 Volume   × Volume   7 Volume   cm Volume in size.
The color of the section Coreference was grey Color red Color and grey Color white Color .
MHL Disease_disorder was diagnosed (Fig.3).
Immunohistochemistry Diagnostic_procedure results Diagnostic_procedure (Fig.4) were the following: mesenchymal Diagnostic_procedure CD34 Diagnostic_procedure ( + Lab_value ), D2–40 ( + Lab_value ), S-100 (-), SMA Diagnostic_procedure ( + Lab_value ), CD7 Diagnostic_procedure (-), epithelium Diagnostic_procedure CK19 Diagnostic_procedure ( + Lab_value ), AFP Diagnostic_procedure (-), HCG Diagnostic_procedure (-).
After 9 Duration days Duration of recovery Therapeutic_procedure , the patient returned Clinical_event home Nonbiological_location without complications Sign_symptom .
A follow Clinical_event - up Clinical_event examination, which included blood Diagnostic_procedure routine Diagnostic_procedure , liver Diagnostic_procedure renal Diagnostic_procedure function Diagnostic_procedure , coagulation Diagnostic_procedure routine Diagnostic_procedure , and ultrasound Diagnostic_procedure scan Diagnostic_procedure at 30 Date days Date , did not show any abnormality Sign_symptom .
No adverse Sign_symptom or Sign_symptom unanticipated Sign_symptom event Sign_symptom was presented.