Original articleFocal nodular hyperplasia in children: clinical features and current management practice☆
Section snippets
Materials and methods
Inpatient and outpatient hospital records were reviewed in all patients identified as having FNH. Clinicopathologic data reviewed included case histories, laboratory results, operative reports, imaging results, pathology reports, and follow-up examinations. The protocol was approved by the Institutional Review Board of Children's Memorial Hospital (Chicago, IL).
The MEDLINE database was reviewed for the period January 1980 to January 2009 to identify pediatric and adolescent cases of FNH.
Institutional experience
Eleven patients with histologically proven FNH were identified between 1999 and 2009 at our institution. The median age at diagnosis was 12.8 years (range, 1-20 years) and 8 were female. Three patients were symptomatic at presentation, whereas 6 were discovered incidentally on computed tomographic (CT) imaging, 1 was found incidentally during laparotomy, and 1 was found incidentally on physical examination. Liver function tests were abnormal in 2 and α-fetoprotein was elevated in 1 patient.
Cumulative experience
A
Discussion
Review of our own experience managing 11 children with FNH, combined with 161 additional patients in the literature, demonstrates that nonoperative management is feasible in an appropriately selected subset of children and adolescents. However, 60% to 80% currently undergo tumor resection because of symptoms, increasing size, or inability to confidently rule out malignancy. Focal nodular hyperplasia occurs in any age group, and approximately 66% of children with FNH are female, compared to a
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