Hepatoblastoma presenting with focal nodular hyperplasia after treatment of neuroblastoma

Gutweiler, Jordan; Yu, David C.; Kim, Heung B.; Kozakewich, Harry P.; Marcus, Karen J.; Shamberger, Robert C.; Weldon, Christopher B.

doi:10.1016/j.jpedsurg.2008.08.069

Cited by 19 publications

(6 citation statements)

References 17 publications

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“…In our experience, one patient with a history of neuroblastoma and biopsy-proven multifocal FNH went on to develop hepatocellular carcinoma concomitant with ongoing FNH in the same location as one of the FNH lesions 12 years later. Gutweiler et al [14] described a child with Goldenhar syndrome who was managed nonoperatively after a biopsy demonstrated FNH but subsequently developed tumor growth and 2 years later was diagnosed with spindle cell tumor. Likewise, Barton and Keller [35] described an 8-year-old child with congenital absence of the portal vein and a liver mass that was diagnosed as FNH by open biopsy despite having elevated α-fetoprotein, who later developed hepatoblastoma in the same location.…”

Section: Discussionmentioning

confidence: 99%

Focal nodular hyperplasia in children: clinical features and current management practice

Lautz

Tantemsapya

Dzakovic

et al. 2010

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Focal nodular hyperplasia in children: clinical features and current management practice

Lautz

Tantemsapya

Dzakovic

et al. 2010

Journal of Pediatric Surgery

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“…Infants with neuroblastoma and metastatic hepatic disease seem to be a specific risk-group for FNH development, especially if they underwent chemotherapy and/or radiation therapy to the liver during treatment [21][22][23] . Gutweiler et al [24] reported a hepatoblastoma case presenting with FNH after treatment of neuroblastoma. FNH should be considered in patients with persistent late imaging changes.…”

Section: Focal Nodular Hyperplasiamentioning

confidence: 99%

Differential diagnosis and management of liver tumors in infants

Fernández-Pineda

Cabello-Laureano

2014

WJH

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During the first year of life, most of the liver neoplasms are benign in origin, but some of these histologically benign lesions may be challenging in their management. Although most hepatic hemangiomas can be safely observed until involution is documented, some patients will need treatment due to progressive hepatomegaly, hypothyroidism and/or cardiac failure. Large mesenchymal hamartomas may require extensive hepatic resection and an appropriate surgical plan is critical to obtain good results. For malignant neoplasms such as hepatoblastoma, complete surgical resection is the mainstay of curative therapy. The decision about whether to perform an upfront or delayed resection of a primary liver malignant tumor is based on many considerations, including the ease of resection, surgical expertise, tumor histology and stage, and the likely chemosensitivity of the tumor. This article reviews the initial management of the more common hepatic tumors of infancy, focusing on the differential diagnosis and treatment options.

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“…This underscores the necessity of open biopsy to confirm a diagnosis when ambiguity exists in the imaging of fine-needle pathologic data surrounding hepatic lesions. Furthermore, although prior chemotherapy may increase risk for developing FNH, [11][12][13][14][15] we are always careful to exclude metastatic or recurrent disease before recommending surveillance alone.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary Management of Focal Nodular Hyperplasia in Children

et al. 2013

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Nonoperative management of focal nodular hyperplasia (FNH) is an accepted paradigm in adults, but current management strategies for children vary substantially between institutions. We reviewed medical records at Johns Hopkins Hospital between January 1, 1998, and December 31, 2008, to investigate the diagnosis, treatment, and outcome of pediatric patients with a pathologic diagnosis of FNH to provide additional data to help formulate management guidelines for this disease. Ten pediatric patients were identified as having a pathologic diagnosis of FNH, either by biopsy sample (n = 5) or hepatic resection (n = 5). The mean age of the patients was 12.1 years, and most were female (n = 7). Mean tumor size was 5.7 cm (range, 0.8-13 cm). Four of 5 patients whose FNH was diagnosed by biopsy alone developed no sequelae, and 1 patient eventually required surgery for mass effect. Patients with either large lesions (≥5 cm) or symptoms were referred for resection. Observational management of small lesions that can be confidently diagnosed as FNH appears to be safe and appropriate. Surgical resection should be reserved for large or symptomatic lesions amenable to resection.

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Hepatoblastoma presenting with focal nodular hyperplasia after treatment of neuroblastoma

Cited by 19 publications

References 17 publications

Focal nodular hyperplasia in children: clinical features and current management practice

Focal nodular hyperplasia in children: clinical features and current management practice

Differential diagnosis and management of liver tumors in infants

Multidisciplinary Management of Focal Nodular Hyperplasia in Children

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