Case 342

Medical history

Woman, 13 years old, looked for medical assistance because of abdominal increasing volume, starting about 6 months ago. Her family suspect of pregnancy. At physical examination: skinny, weight: 30kg (zscore – 2.4), height: 1,54 m (zscore -0.6), anicteric; restrictive respiratory pattern (RR: 22bpm) and abolished breath sound at the base of the right hemithorax. Big abdominal mass without defined limits, petreous consistence without pain on palpation, associated to collateral circulation since upper abdominal level to the neck. Laboratorial exams: diminished levels of albumin and hemoglobin; high levels of gamma glutamyl transferase, alkaline phosphatase and lactate dehydrogenase; normal levels of transaminases, bilirubin, sorologys, alpha fetoprotein and beta hCG. An abdominal ultrasonography confirmed the suspect of a liver mass.

Based at the clinical history and the presented images, what is the most probable diagnosis?

Test question


The most prevalent malign hepatic tumor on childhood is:

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