Online Exclusives
Wandering liver: ultrasound and magnetic resonance imaging diagnosis
“Wandering liver” describes an excessive mobility of the liver caused by abnormalities of hepatic fixation that could lead to hepatic pedicle torsion or bowel obstruction. It is considered a rare entity, but because of the evolution in medical imaging techniques, this unusual condition is being identified more often. We report 2 cases presenting with chronic vague abdominal pain, diagnosed by abdominal ultrasonography and the use of cine–magnetic resonance imaging sequences with dynamic maneuvers.Schwannoma of the diaphragm—a pediatric case report and review of the literature
Diaphragmatic tumors are uncommon and difficult to diagnose in the pediatric population. Schwannoma is a benign, slow-growing peripheral nerve sheath tumor that is most commonly associated with the extremities in childhood. We herein report a schwannoma of the diaphragm in a pediatric patient and review the pediatric literature.Hepatic angiosarcoma of childhood: a case report and review of literature
Angiosarcomas are rare tumors that predominantly affect adults. Hepatic angiosarcoma in a child is an extremely rare event and is associated with a poor prognosis. Herein, we report our experience in a case of hepatic angiosarcoma in a child who presented with a huge unresectable mass that underwent liver transplantation.Prenatal and postnatal ciliated hepatic foregut cysts in infants
Ciliated Hepatic Foregut Cyst (CHFC) is a rare congenital lesion arising from the embryonic foregut. Since squamous cell carcinomas arising from CHFC have been reported in adults, complete resection should be considered. We report our experience with CHFC.Liver transplant for relapsed undifferentiated embryonal sarcoma in a young child
Undifferentiated embryonal sarcoma of the liver is a rare hepatic malignancy of childhood with a historically poor prognosis. Recent improvements in outcomes have been reported in small numbers of cases with the use of combination therapy involving aggressive surgical resection and chemotherapy. Complete surgical resection is frequently difficult to achieve when the location of the tumor is along the margins of the major hepatic vessels (portal vein, hepatic vein, and hepatic artery). Here we report a case of undifferentiated embryonal sarcoma of the liver that recurred along surgical hepatic vein margins in a 9-year-old boy who subsequently underwent orthotopic liver transplantation from a cadaveric donor.Congenital intrahepatic arterioportal fistula presenting as severe undernutrition and chronic watery diarrhea in a 2-year-old girl
Intrahepatic arterioportal fistula (IAPF) is a rare cause of portal hypertension in young children. We report the case of a 2-year-old girl with severe undernutrition, chronic watery diarrhea, and gastrointestinal bleeding because of a congenital intrahepatic arterioportal fistula. Radiographic embolization and surgical ligation of the left hepatic artery were attempted, with no resolution of the symptoms. So, a left lobectomy was performed, with excellent results and prompt disappearance of the diarrhea.Xanthogranulomatous pyelonephritis infiltrating the liver
We report for the first time a patient with a caliceal diverticulum that was detected in early childhood, who in adolescence developed xanthogranulomatous pyelonephritis to the diverticulum and surrounding kidney and infiltrated to the liver. The condition was treated by nonradical organ-sparing surgery and prolonged antibiotic therapy.Cystic undifferentiated sarcoma of liver in children: a pitfall diagnosis in endemic hydatidosis areas
Undifferentiated (embryonal) sarcoma (UES) of the liver is a very rare pediatric neoplasm with an aggressive behavior. Multimodal treatment including complete surgical resection and chemotherapy has improved survival. We report a case of UES occurring in a 15-year-old female. Radiographic findings showed a multicystic mass appearance. The diagnosis of hydatid cyst was initially presumed. A complete tumor resection after 3 cycles of chemotherapy was performed. Histologically, only 20% of tumor necrosis was noted.Left congenital diaphragmatic hernia, absent pericardium, and liver heterotopia: a case report and review
A case of a left congenital diaphragmatic hernia (CDH), absent pericardium, and a hernial sac containing ectopic liver tissue is presented. This triplicate of defects is exceedingly rare with only 2 previous reports in the literature dating back to 1936. This case supports the evidence that CDH is the result of failure of the closure of the pleuroperitoneal canals by the growth of the posthepatic mesenchymal plate. Moreover, the role of the phrenic nerve as a mediator for both CDH and absent pericardium is discussed.
