A rare, primary liver tumor in 4 year old child

A 4 year old male developed a fever and was found to have hepatomegaly, 3- 4 cm below the costal margin. There was a mild tachycardia and the rest of the physical examination was normal. Investigations showed a very high ESR (130 mm/H), with a mild anemia (Hb 9.4 G/dl). Other abnormal investigations included: LDH 664 U/L (normal 94-172), beta chorionic gonadotrophin 11.5 mU/ml (normal 0), alpha-fetoprotein 16 ng/ml (normal <10) and ferritin 332 ng/ml (normal 7-140). Ultrasound and CT of the abdomen revealed that there was a very large tumor in the liver, with areas of hemorrhage and necrosis. The tumor was removed and proved to be an undifferentiated stromal sarcoma of the liver. The tumor was completely resected and, with adjuvant chemotherapy, the prognosis of the patient was considered good.