Focal nodular hyperplasia of the liver in childhood

Nodular regenerative hyperplasia of the liver: description of two cases

Nodular regenerative hyperplasia (NRH) of the liver is a condition of unknown origin, rarely occurring in children, usually accidentally discovered, described in association with a variety of clinical conditions and drugs. Confusion with other types of hepatic masses may pose a problem and for this reason NRH is considered a "tumor-like lesion." Histologically it consists of single or multiple regenerative foci. Hepatic failure and rupture of the liver have been rarely described as complications in adults, and not in children, and malignant transformation has not been demonstrated. Neither surgical removal nor other treatment is needed. These features are described as they were found in two patients we encountered.

Focal nodular hyperplasia of the liver in children: review of follow-up and outcome

The authors used a conservative approach to treat focal nodular hyperplasia of the liver (FNH) and were interested in the long-term results of different therapeutic approaches in order to establish the most appropriate treatment. A review of the literature was conducted, and 31 pediatric case reports were identified in which follow-up and outcome data were noted. Tumor resection was performed in 18 cases (58%), operative biopsy alone in nine (29%), vascular ligation in two, and embolization of hepatic arteries in two. The outcome appears to be good for both groups of patients, ie, those with observation alone and those with resection. More information is to be collected regarding the new procedures (embolization and ligation). This is a retrospective analysis, and data from future international prospective studies are needed.