A rare case of giant hepatic mesenchymal hamartoma in a pediatric patient: diagnostic and surgical challenges

Hepatic mesenchymal hamartoma is a rare benign liver tumor in pediatric patients, typically presenting within the first two years of life. This case involves a 10-month-old female who initially presented with repeated vomiting and was misdiagnosed with a hepatic hemangioma. Subsequent imaging revealed a large, multicystic hepatic mass, and a biopsy indicated spindle cell proliferation, initially suggesting embryonal rhabdomyosarcoma. Due to uncertainty in the initial histopathological diagnosis, the case was discussed in a multidisciplinary team meeting, and the decision was made to proceed with surgical resection. The final diagnosis of hepatic mesenchymal hamartoma was confirmed postoperatively. The patient underwent successful tumor resection, sparing the liver, with no postoperative complications. This case highlights the diagnostic challenges associated with large pediatric hepatic masses and underscores the importance of a multidisciplinary approach for successful outcomes in similar cases.