Focal nodular hyperplasia and hepatic regenerating nodules in pediatric oncology patients: How much invasive approach is necessary?

Introduction. Hepatic regenerating nodules (HRN) and focal nodular hyperplasia (FNH) are benign regenerating lesions of the liver that rarely occur in children. An increased incidence of these lesions is reported in children treated for cancer. Material and methods. Eight children who developed FNH and HRN after treatment for malignancies in the Oncology unit at the "Bambino Gesù" Pediatric Hospital in Rome, were retrospectively analyzed. Results. The lesions, considered in the differential diagnosis with metastatic relapse of the primitive disease, have been monitored with US or other available imaging techniques. Evolution of the lesions was observed in only 1 patient three years after the initial diagnosis of FNH. Conclusion. In conclusion serial monitoring with imaging techniques is sufficient to rule out liver metastasis and to monitor the evolution of the lesions. Surgery is suggested only in the case of complications.