Complete surgical resection of a giant hepatic mesenchymal hamartoma in an infant: a multidisciplinary approach and confirmed disease-free outcome.

Hepatic mesenchymal hamartoma (HMH) is a rare benign paediatric liver tumour. We present an 8-month-old female infant referred with a 2-month history of progressive abdominal distension and poor oral intake. Contrast-enhanced computed tomography identified a massive heterogeneous right hepatic mass measuring 10.7 × 14 × 15.4 cm, extending to the pelvis, crossing the midline, and abutting major vascular structures. Ultrasound-guided Tru-cut biopsy confirmed HMH. Following multidisciplinary team (MDT) discussion, open right hepatectomy was performed achieving complete tumour excision with clear surgical margins of 7 mm. Histopathology confirmed a benign biphasic mesenchymal-biliary proliferation without atypia or malignant transformation. The patient had an uneventful postoperative recovery with preserved liver function. Radiological follow-up at 4 months demonstrated a clear operative bed with no residual or recurrent disease. This case highlights the diagnostic and surgical challenges of giant HMH and the critical role of an MDT approach in achieving curative resection.