Benign Hepatic Nodular Lesions After Treatment for Childhood Cancer

Abstract

In our experience, FNH is the most frequent benign nodular hepatic lesions occurring after treatment for childhood cancer. Hematopoietic stem cell transplantation is the most important risk factor to be taken in account. After a secure diagnosis of these benign lesions, only a close imaging follow-up is recommended.

Focal nodular hyperplasia of the liver: an emerging complication of hematopoietic SCT in children

“…Our data showed an incidence of FNH, among all transplanted patients, of 5.2% (260 times higher than incidence reported in general pediatric population and 11 times higher than the one reported in children with cancer) and a median age at diagnosis of FNH of 14.5 years (range: 8.9-21.7), intermediate between the ones reported by other authors. 2,4,5 In our series, there were three cases of hemangioma (17%), all females who were receiving oral contraceptive therapy, confirming what is known from literature. 4,23 FNH is associated with hepatic hemangioma in 20% of cases 23 and the only variables associated with its development are female sex and the use of oral contraceptives.…”

“…2,4,5 In our series, there were three cases of hemangioma (17%), all females who were receiving oral contraceptive therapy, confirming what is known from literature. 4,23 FNH is associated with hepatic hemangioma in 20% of cases 23 and the only variables associated with its development are female sex and the use of oral contraceptives. 4 In our study, one female was diagnosed with hepatic adenoma, which is known to be associated with FNH.…”

“…FNH could also be an acquired condition, for instance, after a localized vascular injury primed by chemotherapy and RT. 3,4 This would explain the higher incidence of FNH among children treated for cancer (with or without HSCT).…”

“…4,23 FNH is associated with hepatic hemangioma in 20% of cases 23 and the only variables associated with its development are female sex and the use of oral contraceptives. 4 In our study, one female was diagnosed with hepatic adenoma, which is known to be associated with FNH. 9 As malignant transformation from adenoma to hepatocellular carcinoma is rare but well documented, 24 she underwent surgical resection of the mass.…”

“…FNH is a nonmalignant tumor most commonly detected incidentally during ultrasound (US) examination. [1][2][3][4][5][6][7][8] Risk factors are largely unknown and pathogenesis is controversial and not completely understood. Neither complications nor malignant degenerations are described up to now, and the differential diagnosis includes hepatocellular adenoma and fibrolamellar hepatocellular carcinoma.…”