Antenatal diagnosis of congenital hepatoblastoma in utero

A fetus with a huge hepatic tumor was detected by sonography at 36 weeks ge station. The mass appeared as a single, solid and polylobular tumor located in the right lobe of the liver. Foci of hemorrhage, necrosis and some tiny calcifications were seen. The adjacent right kidney appeared normal but wa s displaced. The right adrenal gland was not visualized. Three-dimensional power Doppler sonography further depicted the corresponding vascular anatom y of the tumor, including its vascularization pattern and blood supply. The tumor was situated to the right of the umbilical vein and portal sinus, po ssibly deriving its blood supply from the portal circulation. The fundament al findings suggested the diagnosis of hepatoblastoma by exclusion of other possibilities. The baby was delivered by Cesarean section at 36 weeks' ges tation, due to signs of fetal distress. Unfortunately, hypotension, tachyca rdia, and tachypena developed shortly after birth. Surgical intervention wa s performed, but intractable bleeding occurred intra-operatively. The infan t died at 6 days of age. Autopsy confirmed the diagnosis of hepatoblastoma. We believe this is the first reported case of the antenatal diagnosis of c ongenital hepatoblastoma.