Definition:    Several primary hepatic tumors have been diagnosed prenataly by ultrasound. These include hemangioma, mesenchymal hamartoma, hepatoblastoma and adenoma.

Prevalence: Extremely rare.

Etiology:   No clearly defined factors have been implicated in the development of these tumors.

Ultrasound features: All hepatic tumors may show the same sonographic picture: either a defined lesion (cystic or solid) is present or hepatomegaly exists. Calcifications may appear, and both oligohydramnios and polyhydramnios have been observed.

Ultrasound picture of a hepatic cyst. The yellow arrow aims at the fetal heart. The red arrow marks the cyst. The green arrow aims at the gallbladder.

Prognosis:    Due to the rarity of these tumors little is known about the natural history of these lesions. Hemangiomata are histologically benign and postnatally, the natural history tends towards spontaneous regression after infancy. However, occasionally, hemangiomas are associated with arteriovenous shunting and subsequent congestive heart failure. Heart failure and hydrops with resultant intrauterine and neonatal death have been documented[1].

Reference:

[1] Gonen, R., Fong, K., Chiassen, D.A. Prenatal sonographic diagnosis of hepatic hemangioendothelioma with secondary nonimmune hydrops fetalis. Obstet Gynecol 1989; 73:485-487.