Interpretation of serum alpha-feto protein in an infant with hepatomegaly.

In an oncological setting, the commonest causes of hepatomegaly in infancy are hepatoblastoma, neuroblastoma and vascular tumors (hemangiomas/ hemangioendotheliomas)(l). They often present as asymptomatic liver enlargement. Hence the diagnosis rests on imaging and associated laboratory investigations which need confirmation by histology. Serum alpha-feto protein (AFP) levels often help exclude or confirm a diagnosis of hepatoblastoma. During infancy serum AFP levels have to be interpreted with caution as they remain relatively increased for the first few months after birth (2-4). We report here a 3 1⁄2 month old infant with hepatomegaly, anemia and serum AFP of 700 ng/ ml who posed a diagnostic dilemma.