Introduction
More than 90% of hepatic malignant tumours in paediatric patient are hepatoblastomas. However, we should suspect of hepatocellular carcinoma (HCC) if a patient is older than 10 years old 1). Although most HCCs in adult patients are associated with hepatitis B virus, hepatitis C virus or alcoholic and non-alcoholic fatty liver disease, the causes of HCC in paediatric patients remain unclear1), 2). In adult patients with HCC, hepatectomy, radiofrequency ablation, transcatheter arterial chemoemboliasation (TACE), and liver transplantation are treatment options2). Recently, multikinase inhibitors, including sorafenib and lenvatinib, were approved for treatment of those with HCC3). However, a therapeutic strategy for paediatric patients with HCC has not yet been established. In addition, pathological examination often reveals variations, including fibrolamellar type, epithelial type and clear cell carcinoma1). Transitional hepatic tumours, which have components of both HCC and hepatoblastoma, were also reported in paediatric patients 4), 5). We report a case of refractory transitional hepatic tumour.