Watchful Waiting’ May Be an Appropriate Treatment for ELBW Infant with Hepatic Mesenchymal Hamartoma

Hepatic mesenchymal hamartoma (HMH) is an uncommon benign tumor of childhood. Typically a patient will present with an enlarged, nontender abdominal mass. No specific panel of laboratory tests is characteristic of HMH. Laboratory studies often reveal normal liver function tests and various tumor markers, including human chorionic gonadotropin, alpha fetoprotein, and vanillylmandelic acid, are usually negative. Abdominal ultrasound can demonstrate either a multicystic or solid mass[1] . Although not required for diagnosis, computed tomography and magnetic resonance imaging are useful for surgical planning. Surgery, consisting of either enucleation or lobectomy, traditionally has been the treatment of choice in the postpartum period; however, less invasive techniques, such as laparoscopic fenestration have also been used successfully[2]. Because the natural course of this tumor is initially rapid increase and subsequently decrease in size, some investigators have opted for ‘‘watchful waiting’’ in asymptomatic patients[3] .