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. 2014 Nov 6;71(Suppl 2):S574–S577. doi: 10.1016/j.mjafi.2014.08.006

Table 1.

Common paediatric hepatic masses and their distinguishing features.

Serial number Lesion/Mass Age at presentation Sex AFP levels Characteristic imaging features
1 Infantile haemangioendothelioma <6 months M:F = 1:1.4–2 Normal or mildly elevated
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    Complex mass with enlarged vessels, peripheral nodular enhancement with centripetal fill-in, and calcifications.
2 Mesenchymal hamartoma <2 years M:F = 2:1 Normal or mildly elevated
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    Large multilocular cystic mass with thin/thick echogenic septae and solid areas on USG.

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    Unencapsulated complex cystic mass; fluid attenuation/intensity of cyst contents on CT/MRI; enhancement of septae/solid areas.
3 Hepatoblastoma <3 years M:F = 2:1 Markedly elevated
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    Solid mass with calcifications and occasionally cystic areas (necrosis) on USG.

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    Inhomogeneous mass on CT/MRI with heterogeneous and peripheral enhancement; haemorrhage on MRI
4 Undifferentiated embryonic sarcoma 6–10 years M:F = 1:1 Normal
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    Complex cystic mass with necrosis and haemorrhage.
5 Hepatic cyst (congenital or acquired) – – Normal
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    Simple cyst on USG, CT, MRI
6 Intrahepatic choledochal cyst (Todani type 4a) – M:F = 1:3–4 Normal
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    Communication with the biliary tree demonstrable on MRCP and scintigraphy.

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    Associated cysts of the extrahepatic biliary tree.
7 Echinococcal cyst type II (cyst with daughter cysts and matrix) – – Normal
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    Multilocular cystic lesion with central mother cyst and peripheral daughter cysts. Attenuation of central mother cyst is higher than that of daughter cysts. Mural calcifications and floating membranes and may be seen.

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    Slow growth rate; unlikely diagnosis in infants
8 Pyogenic abscess – – Normal
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    A cluster of abscesses may coalesce into a single larger cavity ‘cluster sign’ with a characteristic ‘double target sign’ on CT.

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    Enhancing wall, septae and ‘periabscess’ are characteristic on MRI.
9 Haematoma – – Normal
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    Secondary to trauma, surgery, coagulation disorders, HELLP syndrome, rupture of hypervascular neoplasms.

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    Variable and changing appearance depending on elapsed time.
10 Biloma – – Normal
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    As a result of traumatic/iatrogenic injury to biliary tree.

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    Well-defined unilocular subcapsular or intrahepatic cystic lesions with water attenuation or signal intensity. A minority of cases are complicated by septae.