Mesenchymal Hamartoma of the Liver: A Clinicopathological Analysis of Patients at a Tertiary Care Facility.

Mesenchymal hamartomas of the liver (MHL) are the second most common benign liver tumor. It occurs almost exclusively in children and infants and primarily affects men. Clinical symptoms, imaging tests, and laboratory investigations could be inconclusive. An accurate diagnosis usually requires a biopsy or surgical resection. Conservative and surgical treatments are available, and the prognosis is favorable. The true incidence is unknown since only a few publications have been published on MHL. Here, we describe our experience with eight cases, aiming to provide a better understanding of this rare disease. This study included all patients from 2010-2023 (SGPGIMS) with hepatic mesenchymal hamartoma who underwent liver biopsy or surgical excision. This study identified eight MHL cases from 5268 hepatic biopsies and surgical specimens. The median age at presentation was ten months (9 months to 52 years). Patients presented with abdominal pain (5/8; 62.5%) and masses (5/8; 62.5%). The diameter ranges from 6.2 to 18.7 cm (mean is 12.8 cm). Ultrasonography and computed tomography were diagnostic in only 4 (50%) patients. It is histopathology that provides the most accurate diagnosis. Most tumors (6/8; 75%) are solid-cystic with well-defined margins. Follow-up data were available for six patients; the median duration was 15 months. The patients are all alive, and there is no evidence of recurrence or malignant transformation. Laboratory values, computed tomography, and biopsy can be used preoperatively to make a presumptive diagnosis. Once a diagnosis has been made, it is recommended that all patients undergo tumor excision. Mesenchymal hamartomas may present nonspecific signs and symptoms. Advanced imaging and expertise help diagnose them. Histopathology is the gold standard for diagnosis, and complete surgical resection is the recommended treatment.