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Benign Hepatic Nodular Lesions After Treatment for Childhood Cancer

Masetti, R.*; Colecchia, A.; Rondelli, R.*; Martoni, A.*; Vendemini, F.*; Biagi, C.*; Prete, A.*; Festi, D.; Lima, M.; Pession, A.*

Journal of Pediatric Gastroenterology & Nutrition: February 2013 - Volume 56 - Issue 2 - p 151–155
doi: 10.1097/MPG.0b013e31826f7660
Original Articles: Hepatology and Nutrition

Background: Benign nodular hepatic regenerating lesions such as focal nodular hyperplasia (FNH) have been reported as rare complications of the antineoplastic therapy received during infancy. Little is known about the risk factors associated with the onset of these lesions and their diagnostic management.

Methods: We have analyzed a series of benign hepatic nodular lesions occurring in children previously treated for malignant tumors in our institution in a period of 11 years. An extensive description of the imaging presentation of the lesions has been provided to facilitate the differential diagnosis, and a risk factor analysis has been conducted.

Results: A total of 14 diagnoses (10 FNH and 4 hemangiomas) of benign nodular hepatic lesions have been found. Hematopoietic stem cell transplantation is the most important statistically independent risk factor associated with the development of these lesions, especially for FNH. No malignant transformation of nodules has been recorded during a median follow-up time of 4 years.

Conclusions: 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.

*Paediatric Oncology and Haematology Unit Lalla Seràgnoli

Department of Clinical Medicine

Department of Paediatric Surgery, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.

Address correspondence and reprint requests to Riccardo Masetti, Paediatric Oncology and Haematology Unit Lalla Seràgnoli, Sant’Orsola-Malpighi Hospital, Via Massarenti 11, 40137 Bologna, Italy (e-mail:

Received 11 April, 2012

Accepted 13 August, 2012

The authors report no conflicts of interest

Copyright 2013 by ESPGHAN and NASPGHAN