Focal nodular hyperplasia in children
Ts. Mancheva, S. El Shemeri, B. Balev, N. Rasheva, M. Georgieva
Focal nodular hyperplasia (FNH) is a rare benign tumor of the liver, which is extremely rare reported in children. We present a case of 6-month-old female. The infant was reffered to the hospital for further investigation of incidentally established heterodense mass in the liver. Ultrasound and CT examinations were performed. They were combined with laboratory and viral serologic tests. The liver function tests were normal, except AFP. Viral serologic tests for hepatitis B and C were negative. Abdominal ultrasound revealed a heterodense mass, well-defined from the surrounding liver tissue. On Doppler examination, the blood supply is proven to be from a large artery. The findings on CT imaging include a solitary, homogeneous, and slightly hypoattenuating mass compared to the surrounding liver on unenhanced CT. After administration of i.v. contrast the lesion demonstrates rapid homogeneous contrast enhancement at the arterial phase (except for the central scar). On venous phase, the mass becomes isodense as compared to the surrounding liver. Although the diagnosis of FNH in children can be challenging for the radiologist, different imaging modalities like ultrasound, CT and MRI all offer specific advantages in the detection.
Key words: FOCAL NODULAR HYPERPLASIA. IMAGING DIAGNOSTIC. PEDIATRIC. TUMOURS IN CHILDREN