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Focal nodular hyperplasia in children: clinical features and current management practice

Timothy Lautz1, Niramol Tantemsapya, Alexander Dzakovic

  • 1Department of Surgery, Children's Memorial Hospital, Feinberg School of Medicine of Northwestern University, Chicago, IL 60614, USA. t-lautz@northwestern.edu

Journal of Pediatric Surgery
|September 21, 2010
PubMed

Insights

Focal nodular hyperplasia (FNH) in children often requires surgical resection due to symptoms or uncertainty about malignancy, unlike adults. Current management prioritizes safety over nonoperative approaches for pediatric FNH.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Oncology
  • Hepatology

Background:

  • Focal nodular hyperplasia (FNH) is typically managed nonoperatively in adults.
  • The safety and feasibility of nonoperative management for FNH in children remain unclear.

Purpose of the Study:

  • To review the clinical features of pediatric focal nodular hyperplasia.
  • To determine current management patterns for FNH in children.

Main Methods:

  • Retrospective review of pediatric FNH cases managed at a single institution (1999-2009).
  • MEDLINE search to identify all published pediatric FNH cases.
  • Analysis of clinical features, tumor characteristics, and management strategies.

Main Results:

  • 172 pediatric FNH cases identified; median age 8.7 years, 66% female.
  • 36% of patients were symptomatic; 24% had a history of malignancy.
  • Resection was performed in 61% of cases, often due to symptoms, malignancy concerns, or tumor growth.

Conclusions:

  • Most children with FNH undergo resection, differing from adult management.
  • Indications for resection in children include symptoms, inability to rule out malignancy, and tumor growth.
  • Current pediatric FNH management prioritizes surgical intervention over nonoperative strategies.
Abstract

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