We report the case of a 27-year-old man, born in Guinea, with chronic hepatitis B (HBsAg+, HBcAc+, HBeAc+ and HBeAg-5,3 x lobe), with a large liver mass.
The lesion showed typical uptake in arterial phase with a dubious washout in late phases and alpha-fetopreothein was 1,166,000 ng/ml.
The findings underwent a right hepatectomy slightly extended to the hepatic segment IV to achieve a free resection margin (R0).
At harvest, the lesion was solid, white-yellow, with an irregular multinodular appearance, with areas of necrotic appearance and other areas of whitish color and myxoid appearance.
Histopathological study showed the presence of a malignant neoplasm with characteristics suggestive of mixed fetal and embryonic epithelial hepatoblastoma.
The immunohistochemical study confirmed the diagnosis.
Subsequently, the patient received adjuvant chemotherapy according to the SIOPEL 4 scheme.
After 15 months of follow-up, a left adrenal recurrence was detected after PET-CT.
Open adrenalectomy was performed with complete resection of the lesion (R0).
After 12 months of follow-up since the treatment of adrenal recurrence, the patient has not presented new signs of recurrence.
