Infantile Hemangioendothelioma with a Highly Elevated Serum Alpha-fetoprotein Level: Report of a Case

Infantile hemangioendothelioma of the liver is the most common primary pediatric mesenchymal tumor during the first year of life, with 80%-90% of tumors occurring during the first 6 months of life. A full-term, newborn girl was found to have an abdominal mass after delivery. Abdominal ultrasonography and computed tomography (CT) demonstrated diffuse left hepatic nodules with fine curvilinear calcification. A highly elevated alpha-fetoprotein (AFP) level misled us to the impression of hepatoblastoma; however, the pathologic reports through a surgical resection disclosed liver hemangioendothelioma. The patient did well 3 weeks after surgery. This case emphasizes that an elevated AFP level of up to 400 ng/ml is normally found in some neonates until two months of age﹒Careful interpretation of this value is very important, especially when it is associated with a hepatic tumor.