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Pathological Case of the Month

Amira Helal, MD, MRCP; Michael Nolan; Richard Bower, MD; Buff Mair, MD; Diane Debich-Spicer
Arch Pediatr Adolesc Med. 1995;149(3):315-316. doi:10.1001/archpedi.1995.02170150095018.
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A 10-MONTH-OLD previously healthy girl presented with a 3-month history of an abdominal mass. This mass was detected at a 6-month checkup by a primary care physician. The results of liver and kidney function tests as well as of a hepatic panel were all negative. No further workup was done. The infant was brought in because of a progressive increase in the size of the mass. She was otherwise asymptomatic and was gaining weight appropriately.

The mother vaguely recalled questions of a possibly enlarged liver in the neonatal period. Examination revealed a healthy-looking, active, happy little girl who appeared well developed and well nourished. No jaundice was detected. A 13-cm, firm, nontender mass was palpable in both the upper- and lower-right quadrants. Bowel sounds were audible only in the lower-left quadrant. Results of a complete blood cell count, an electrolyte analysis, and a liver function test were normal. An abdominal


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