Hepatic focal nodular hyperplasia in children and liver transplantation

Abstract

Focal nodular hyperplasia (FNH) is a benign tumour probably arising secondary to an altered vascularization of the hepatic parenchyma. It is rare in the paedriatric age group. We report a patient with FNH who underwent orthotopic liver transplantation (OLT) and we review the literature with respect to therapeutic approaches in treatment of FNH. A 15 year old boy presented with a palpable abdominal mass. Abdominal ultrasound and a CT scan showed multifocal tumours in both hepatic lobes. These were unresectable and a biopsy confirmed the diagnosis of FNH. The patient developed portal hypertension secondary to portal vein compression, with ascites, encephalopathy and renal failure. The decision between an expectant approach versus a surgical approach should be based on individual findings in each case. OLT is a therapeutic alternative in patients with benign unresectable liver tumours.