Multidisciplinary management of focal nodular hyperplasia in children: Experience with 10 cases

Gezzer Ortega, Mitchell Price, Shelly Choo, Seth D. Goldstein, Dylan Stewart, Fizan Abdullah

Research output: Contribution to journalArticlepeer-review

Abstract

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 mostwere 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.

Original languageEnglish (US)
Pages (from-to)1068-1070
Number of pages3
JournalJAMA surgery
Volume148
Issue number11
DOIs
StatePublished - Nov 1 2013

ASJC Scopus subject areas

  • Surgery

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