Anastomosing hemangioma of the liver in infant: A case report

Anastomosing hemangiomas represent a rare variant of benign vascular hemangioma which rarely arise from the liver parenchyma. The peculiarity of these tumors is that they can mimic malignant tumors, such as hepatocellular carcinoma, hepatoblastoma, and angiosarcoma. Notably, all documented cases where this type of liver tumor was described in the world's literature exclude cases involving infant patients. Our clinical case demonstrates the presence of an anastomosing hemangioma in the right lobe of the liver in a 5-month-old child, necessitating radical surgical intervention. According to ultrasound and CT scan findings, a tumor measuring 7.5 by 6 by 4.5 cm was detected in the segments V, VII and VIII of the liver. A differential diagnosis between hepatoblastoma and angiosarcoma was conducted. Blood tests, including alpha-fetoprotein levels, were within normal limits. Percutaneous biopsy revealed no cellular atypia, while immunohistochemical examination identified anastomosing hemangioma positive for CD-31 and CD-34 staining. Given the size of the tumor, an anatomical right hepatectomy was performed. The patient was discharged on the 7th postoperative day without surgical complications. After 6 months, no recurrence of the tumor was detected. This particular case highlights the importance of differential diagnosis of this type of tumor in children since anastomosing hemangiomas can mimic malignant liver tumors.