Cystic hepatoblastoma in an adolescent: A case report

Introduction: Hepatoblastoma accounts for approximately 1 % of pediatric tumors. It occurs mainly between 6 months and 3 years of age and is extremely rare in adolescents and adults. Hepatoblastoma generally presents as a painless abdominal mass discovered incidentally. We report a case of painful cystic hepatoblastoma in an adolescent, that was initially thought to be an amebic liver abscess. Case presentation: A 15-year-old male with no significant medical history was admitted to the emergency department with right hypochondrium pain, fever, and vomiting for 14 days. Abdominal examination revealed hepatomegaly with a tender liver, firm surface, and well-defined inferior edge. A contrast-enhanced abdominal CT scan was done, demonstrating a suspected amebic liver abscess in segments S4 – S5. The patient was taken to the operating room. The abscess was punctured and drained, and a biopsy of the wall was taken. All this was done laparoscopically. The pathology of the cyst wall was consistent with hepatoblastoma. The patient was brought back to the operating room after 3 weeks and underwent a complete resection of the cystic tumor through a partial hepatectomy. The patient's postoperative course was uneventful, and he was discharged 5 days after the operation. Histological examination of the surgical specimen confirmed the diagnosis of hepatoblastoma. Conclusion: Hepatoblastoma is extremely rare in adolescents. Cystic hepatoblastoma should be included in the differential diagnosis of a hepatic cyst, regardless of the patient's age, even in areas where infectious hepatic cysts are widely prevalent

Ileocolic intussusception caused by a submucosal ileal lipoma in a teenager: A case report

Introduction: Intussusception is a rare condition in adolescents; its incidence is highest between three months and three years of age. The symptoms of intussusception are abdominal pain and bowel obstruction. Organic origin is the most common etiology of intestinal intussusception in adolescents, unlike pediatric intussusception, which is usually idiopathic. Adolescent intussusception due to ileal submucosal lipoma is infrequent, and only a few cases have been reported in the medical literature. Case presentation: A 14-year-old female patient was admitted to the emergency department with abdominal pain, nausea, and bilious vomiting. She had no significant medical history. The abdominal examination revealed typical signs of acute bowel obstruction. An enhanced abdominal CT scan showed an invagination of the distal ileal loop within the ascending colon lumen with a rounded fat aspect. Emergency laparoscopic-assisted right hemicolectomy and ileocolic anastomosis were performed. The patient recovered well and was discharged three days after surgery. Histological examination of the surgical specimen confirmed the diagnosis of intussusception due to an ileal submucosal lipoma. Conclusion: The symptoms of bowel intussusception due to an ileal submucosal lipoma in adolescents are similar to any other bowel intussusception due to other etiologies. A contrast-enhanced abdominopelvic CT scan and histopathological analysis are valuable techniques to achieve the correct diagnosis