Ruptured hepatoblastoma with massive internal bleeding in an adult

Figure 1 CT scans of the abdomen showed massive accumulation of intra-abdominal fluid and one large heterogeneous mass (c 11. 4 cm×8.8 cm×2 cm) with cystic and solid components in the left lobe of the liver.

Figure 2 Catheter angiography showed a huge hepatic tumor with faint tumor blush in the left lobe and a 2. 5 cm large hypervascular tumor in the right lobe. These were presumed to be hepatocellular carcinomas.

Figure 3 The specimen recovered consisted of an encapsulated mass measuring 22 cm×6 cm×5 cm in size with extensive necrosis and hemorrhage. Grossly, it was friable and soft in consistency.

Figure 4 Immature hepatocytic epithelial elements intermixed with prominent vessels and extramedullary hematopoiesis including all three lineages (A). Vimentin positive (B); MPO positive for the extramedullary hematopoietic myeloid series (C); factor 8 positive for extramedullary hematopoietic megakaryocytes (D).