Born to Fight—Case series of a single centre experience of Congenital Hepatoblastomas

Abstract Introduction Congenital hepatoblastoma (CHB) is a rare subset of hepatoblastoma presenting in the neonatal period or early infancy, accounting for less than 10% of cases. Historically considered aggressive, outcomes have improved with multimodal therapy. Case-Presentations We report four infants presenting within the first two months of life with abdominal mass, predominantly in the right upper quadrant, and markedly elevated alpha-fetoprotein levels. Antenatal imaging was normal in all cases. Imaging revealed hepatic masses ranging from 8.4 to 10.4 cm. All patients underwent early surgical resection with histopathological confirmation of CHB, followed by cisplatin-based chemotherapy. Three had pure fetal histology, and one had mixed epithelial and mesenchymal features. All patients remain alive and disease-free at follow-up ranging from 4.3 to 12.7 years. Conclusion CHB, though rare, has favorable outcomes with timely surgical resection and chemotherapy. A multidisciplinary approach is essential to optimize survival in these challenging neonatal cases.