Hepatic hemangioendothelioma: Prenatal sonographic findings and evolution of the lesion

We describe a case of hepatic hemangioendothelioma that was first suspected based on prenatal sonographic findings at 19 weeks' menstrual age. At 16 w eeks, the patient presented with a markedly elevated maternal serum alpha-f etoprotein level. Serial sonographic examinations revealed that the fetus h ad cardiomegaly, hepatomegaly with a hepatic mass and dilated intrahepatic vessels, a single umbilical artery, and a placental chorioangioma. Arteriov enous shunting within the hepatic mass was seen using color Doppler and pul sed Doppler sonography. An enlarged artery arising from the abdominal aorta supplying the mass was demonstrated. Postnatal physical examination and ra diologic studies supported the diagnosis of hepatic hemangioendothelioma. T he evolution in the sonographic appearance of this hepatic lesion in utero over a 17-week period is described. (C) 2000 John Wiley & Sons, Inc.