Hepatic transplantation in a child with giant multicystic tumor: Pathological and imaging findings Primary hepatic tumors comprise between 0.5 and 2% of all tumors in children. Two-thirds are malignant: hepatoblastoma, hepatocellular car- cinoma, and embryonal sarcoma. The latter is also called primary sarcoma, undifferentiated embryonal sarcoma or malignant mesechymoma. Benign tumors represent one-third of all primary hepatic tumors in children. The more frequently occurring tumors are infantile hepatic hema- gioendothelioma and MH. The MH affects children younger than two yr old, occurs more frequently in boys, and presents as a mass with cysts of several sizes. While its etiology is unknown, various hypotheses include developmental anomalies of ductal plaque, regional ischemia, inflammatory activity, and chromosomal alteration (1–3). The radiological findings of MH range from a multilocular mass containing cystic areas that are separated by thick and enhancing septa to that of a predom- inantly solid mass containing multiple small cysts. The solid parts of the mass are enhanced following intravenous administration of contrast medium. UES of the liver was first described by Stocker and Ishak in 1978. It is a rare malignant tumor appearing in children between 6 and 10 yr old, and accounts for about 13% of hepatic malig- nancies. It is believed to be the malignant counterpart of the MH, and some authors have described it as a malignant transformation from MH. The radiological findings reveal a large, well demarcated and predominantly low attenuation mass containing hyperdense septations and Castrillon GA, Sepu´lveda E, Yepez NL, Hoyos S, Osorio G. Hepatic transplantation in a child with giant multicystic tumor: Pathological and imaging findings. Pediatr Transplantation 2010: 14: e58–e61. Ó 2009 John Wiley & Sons A/S. Abstract: A 30-month-old male white child presented with 13 months of increasing abdominal girth. The MRI and MDCT showed a giant heterogeneous and predominantly cystic mass with thick and nodular septation, measuring approximately 18 · 15 · 20 cm, which occupied almost the whole liver. A histological diagnosis was not possible, which necessitated transplantation. One yr after transplantation the course has been satisfactory without recurrence and with normal hepatic function and negative tumor markers. Germµn A. Castrillon 1 , Elsy Sepffllveda 2 , Nora L. Yepez 2 , Sergio Hoyos 3 and Germµn Osorio 4 1 Department of Radiology and Gastrohepatology Group, Universidad de Antioquia, Medellín, Colombia, 2 Department of Pediatric and Gastrohepatology Group, Universidad de Antioquia and Hospital Pablo Tobon Uribe, Medellín, Colombia, 3 Department of Surgery and Gastrohepatology Group, Universidad de Antioquia and Hospital Pablo Tobon Uribe, Medellín, Colombia, 4 Department of Pathology and Gastrohepatology Group, Universidad de Antioquia, Medellín, Colombia Key words: hepatic – cystic – tumor – transplantation – pathological – imaging Germµn A. Castrillon, Calle 11 A No 31 A 3, Apto 103 Medellín, Colombia Tel.: 574-2684805 Fax: 574-2123087 E-mail: germancastrillon@une.net.co Accepted for publication 27 January 2009 Abbreviations: CT, computed tomography; MDCT, multi- detector computed tomography; MH, mesenchymal ha- martoma; MRI, magnetic resonance imaging; UES, undifferentiated embryonal sarcoma. Pediatr Transplantation 2010: 14: e58–e61 Ó 2009 John Wiley & Sons A/S. Pediatric Transplantation DOI: 10.1111/j.1399-3046.2009.01166.x e58