Focal nodular hyperplasia of the liver following hematopoietic SCT

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.…”

“…2,3,5,25 In our transplanted patients' group, lesions involved the liver in multiple sites showing smaller average diameters. A standardized nomenclature was first proposed in 1994, placing FNH in the group of regenerative nodules, as opposed to dysplastic or neoplastic nodules.…”

“…20 It is unusual in children, representing 2% of all pediatric hepatic tumors, with an incidence of~0.02% in the general pediatric population, which seems to be higher in children previously treated for cancer. 2,5,21,22 These data are probably underestimates as nodules are incidentally detected during imaging examinations performed for other reasons. There are few reports about FNH in pediatric oncology: the largest series, all dealing with HSCT patients, were described by Bouyn, 2 Masetti 3,4,7 and Sudour.…”

“…There are few reports about FNH in pediatric oncology: the largest series, all dealing with HSCT patients, were described by Bouyn, 2 Masetti 3,4,7 and Sudour. 5 Smith et al 6 reported 46 cases of FNH (incidence 5.1%), focusing on the specific subset of solid tumor pediatric patients (regardless of HSCT status), without a description of the previous treatments' details nor a risk factor analysis.…”

“…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.…”