Related Experiment Video
Updated: Sep 11, 2026
Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
Focal nodular hyperplasia and adenoma of the liver. A pediatric experience
Insights
Focal nodular hyperplasia and hepatic adenoma are rare childhood liver tumors. Differentiating these benign conditions is crucial for proper management, as highlighted by distinct clinical presentations and pathological findings in four pediatric cases.
Area of Science:
- Pediatric Hepatology
- Surgical Pathology
- Diagnostic Imaging
Background:
- Focal nodular hyperplasia (FNH) and hepatic adenoma (HA) constitute about 2% of primary hepatic tumors in children.
- These benign liver lesions can present with varied clinical symptoms, from asymptomatic hepatomegaly to life-threatening hemorrhage.
Purpose of the Study:
- To report the clinical and pathological features of FNH and HA in pediatric patients.
- To emphasize the importance of differentiating between FNH and HA due to their distinct presentations and management implications.
Main Methods:
- Retrospective review of clinical data and pathological findings in four pediatric patients diagnosed with FNH or HA.
- Analysis of imaging characteristics, including angiography, to assess vascularity and lesion morphology.
Main Results:
- Three female children with FNH presented with asymptomatic hepatomegaly.
- One 14-year-old female with HA experienced massive hemoperitoneum due to a ruptured hemorrhagic mass.
- Angiography revealed hypervascular lesions with abnormal vessels in both FNH and HA, mimicking malignancy.
- Pathological examination allowed clear differentiation between FNH and HA.
Conclusions:
- FNH and HA in children have distinct clinical presentations.
- Accurate pathological differentiation is essential for appropriate patient management.
- Despite concerning imaging findings, both FNH and HA were successfully managed in these cases.
Abstract:
Focal nodular hyperplasia and adenoma of the liver together represent approximately 2% of all primary hepatic tumors and tumor-like lesions in childhood. This study reports the clinical and pathologic features of focal nodular hyperplasia in three children, all females between 27 months and 15 years of age with asymptomatic hepatomegaly. In contrast, massive hemoperitoneum from a ruptured, hemorrhagic mass was the presentation of the hepatic adenoma in a 14-year-old girl. There was no history of administration of steroids in these four children. Angiography in two cases (one case each of focal nodular hyperplasia and hepatic adenoma) revealed hypervascular lesions with abnormal tortuous vessels suggesting a malignant tumor. Pathologically, the adenoma and focal nodular hyperplasia were readily distinguishable and the necessity for this differentiation was reviewed. All four patients are currently doing well.
