Hepatoblastoma in Infant: A Rare Case Report and Literature Review

Introduction: Hepatoblastoma is the most common liver malignancy in children. Hepatoblastoma in infants is rare and usually presents as an abdominal mass without specific symptoms. Diagnosis is difficult, supported by adequate imaging modalities, liver biopsy, and hepatoblastoma marker testing. Case Presentation: A 3-month-old boy presented with a chief complaint of abdominal mass 3 days after birth without any other complaints. Nutritional status was normal. Vital signs were stable. Physical examination revealed anemic conjunctiva, hepatomegaly, and a palpable lump in the right upper quadrant of the abdomen. The laboratory results were Hb 8.2 g/dL, AST 45 U/l, ALT 13 U/L, gamma-GT 218.2 U/L, alkaline phosphatase 200 U/L, total bilirubin 3.00 mg/dL, direct bilirubin 1.40 mg/dL, Rubella IgG Reactive (20.60 IU/mL), CMV IgG Reactive (145.1 AU/mL), LDH 404 U/L, and Alpha-fetoprotein 5720.45 ng/mL. Abdominal ultrasound was consistent with a malignant liver mass, possibly hepatoblastoma, with a heteroechoic mass +/- 6.57 x 7.21 x 6.76 cm in the right and left liver lobes. A computed tomography scan of the abdomen confirmed the hepatoblastoma in segments V, VI, VII, and VIII of the right lobes with hepatomegaly. Conclusion: The possibility of hepatoblastoma should be considered when an infant presents with a complaint of an abdominal mass without specific symptoms. In children younger than 2 years, radiologic confirmation of hepatoblastoma is sufficiently accurate, especially when supported by elevated AFP in facilities with limited liver biopsies