EP06.24: Fetal hepatic hemangioma with atypical ultrasound presentation

A 32-year-old primigravida, presented at Fetal Medicine Unit of the Clinical Hospital of the University of Chile at 23+3 weeks of gestation with a suspected fetal hepatic lesion. Initial evaluation revealed an intrahepatic, hyperechogenic lesion measuring 13x12x17 mm, regular borders and minimal posterior acoustic shadowing and no evident vascularisation on Doppler. At 27 weeks, nuclear magnetic resonance imaging (MRI) confirmed the presence of a hepatic nodule suggestive of hemangioma, measuring 13x11x10 mm. Serial ultrasound monitoring showed minimal changes with the disappearance of acoustic shadow and the emergence of minimal flow on Doppler observed only during the last evaluation at 34+4 weeks, when the patient was referred to her primary care centre for delivery, performed at 39 weeks. The newborn, weighing 3777 grams, had an uneventful neonatal period. Postnatal ultrasonographic evaluation of the hepatic lesion confirmed the presence of a hemangioma, warranting only periodic follow-up. Hepatic tumours are rare in the fetus a, comprising 5% of all tumours within this demographic. Between primary tumours, hepatic congenital hemangiomas (HCM) are the most prevalent and emerge as a well-defined, solid hypoechoic mass with high-flow on Doppler. Presentation with no evidence of vascularisation on Doppler and subsequent MRI findings highlight the importance of complementary imaging modalities in confirming inconclusive diagnoses. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.