# When the Belly Looks Okay but Is Actually Not: A Case of Hepatoblastoma in a Well-Appearing Child

## TL;DR

A 13-month-old child with a normal appearance but abdominal distention was diagnosed with hepatoblastoma, highlighting the importance of early detection.

## Contribution

This case report highlights hepatoblastoma's subtle presentation and emphasizes diagnostic approaches for early-stage detection.

## Key findings

- A well-appearing child with abdominal distention was found to have hepatoblastoma.
- Abdominal imaging and lab results confirmed hepatoblastoma despite normal vital signs.
- The tumor was successfully resected and followed by chemotherapy.

## Abstract

Hepatoblastoma is one of the pediatric tumors with genetic and intrauterine risk factors. It is typically asymptomatic at diagnosis, at which time most patients have metastasis to the lungs and are in an advanced stage of liver disease. We report an interesting case of a 13-month-old child who presented with a one-month history of abdominal distention. A review of the systems was unremarkable but a physical examination revealed a well-appearing child with abdominal distention, normal vital signs, and an abdominal mass. Abdominal imaging revealed a well-defined heterogeneously-enhancing mass arising from the right hepatic lobe and laboratory results were consistent with a diagnosis of hepatoblastoma. The mass was resected and the patient underwent chemotherapy with continued follow-up management. We shed light on pediatric hepatoblastoma and its clinical presentation, pathology, and laboratory and imaging findings, to aid clinicians in diagnosing the condition correctly.