Introduction: Congenital hepatoblastoma (CHB) is an uncommon form of liver cancer in infants that tends to be identified either in utero or during the initial month of life. This malignancy tends to progress rapidly in its early stages. Case Presentation: We describe a 10-day-old Arab female newborn with a hard and demarcated abdominal metastasis situated in the right upper quadrant, slightly crossing over into the left iliac fossa. Laboratory findings included significantly high alpha-fetoprotein (AFP) of 663,600 ng/mL, elevated white blood cell and platelet counts, and mild anemia. Imaging studies evidenced a 7 × 7 cm liver tumor involving segments VI and VII with arterial enhancement and necrosis and dilatation of intrahepatic biliary ducts without metastasis. Fine-needle aspiration was positive for fetal/embryonal-type hepatoblastoma. PRETEXT-I staging showed a very low risk. The infant underwent nine cycles of cisplatin-based chemotherapy that significantly reduced tumor size and vascularity and could be easily surgically removed. Post-chemotherapy recovery was uncomplicated, and follow-ups a year after treatment showed normal growth and AFP levels. Conclusion: This particular case illustrates the need for prompt diagnosis and management of CHB patients by combining chemotherapy and surgery. It should be noted that even in the absence of associations or classic risk factors in neonates, an abdominal mass should not be overlooked.
Alnahar et al. (Mon,) studied this question.