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Multiple focal nodular hyperplasias induced by oxaliplatin-based chemotherapy
Matteo Donadon1, Luca Di Tommaso, Massimo Roncalli
1Matteo Donadon, Guido Torzilli, Liver Surgery Unit, Department of General Surgery, University of Milan, Humanitas Clinical and Research Center, 20089 Rozzano, Milan, Italy.
World Journal of Hepatology
|June 28, 2013
Summary
Oxaliplatin chemotherapy can cause liver injuries, including focal nodular hyperplasia (FNH), mimicking colorectal liver metastases. Accurate diagnosis is crucial for effective colorectal cancer management and avoiding unnecessary liver resections.
Area of Science:
- Hepatology
- Medical Oncology
- Diagnostic Imaging
Background:
- Focal nodular hyperplasia (FNH) is a benign liver condition.
- Oxaliplatin, used for colorectal cancer, is increasingly linked to liver injuries and focal lesions.
- Misdiagnosis of these lesions as colorectal liver metastases (CLM) can lead to inappropriate treatment.
Purpose of the Study:
- To report two cases of multiple bilateral liver lesions misdiagnosed as CLM in patients treated with oxaliplatin.
- To highlight the importance of considering oxaliplatin-induced FNH in patients with colorectal cancer.
- To emphasize the role of accurate diagnosis in managing liver lesions during cancer therapy.
Main Methods:
- Case report of two patients with multiple liver lesions after oxaliplatin chemotherapy.
- Diagnostic imaging including MRI and CT, alongside FDG-PET scans.
- Histopathological examination following parenchyma-sparing liver surgery.
Main Results:
- Both patients presented with multiple bilateral liver lesions initially suspected as CLM.
- Imaging findings were suggestive of CLM, and FDG-PET scans were negative.
- Histopathology confirmed the diagnosis of multiple FNHs, not metastases.
- Both patients underwent successful parenchyma-sparing liver surgery.
Conclusions:
- Oxaliplatin-based chemotherapy can induce FNH, which may be misdiagnosed as CLM.
- Awareness of oxaliplatin-induced liver injury is critical for accurate diagnosis in colorectal cancer patients.
- Multidisciplinary management and precise risk-benefit assessment are essential for optimal patient care.
