So Young Yoo MD, Presenter: Nothing to Disclose

Tae Yeon Jeon MD, Abstract Co-Author: Nothing to Disclose

Ji Hye Kim MD, PhD, Abstract Co-Author: Nothing to Disclose

Hong Eo, Abstract Co-Author: Nothing to Disclose

Occurrence of benign hepatic nodule such as focal nodular hyperplasia (FNH) has been increasingly reported in the childhood cancer survivors. Incidental discovery of a hepatic nodule is diagnostic challenging in the setting of treated malignancy. The purpose is to investigate the dynamic MR imaging findings and clinical features of benign hypervascular hepatic nodules developed in a group of childhood cancer survivors.

We reviewed dynamic MR imaging findings and clinical features in 15 patients (F:M 10:5; mean age 12.7 years, range 8~20 years) who had been treated for childhood malignant solid tumors and, later, showed hypervascular hepatic nodules on surveillance CT and/or US. Benign nature of the lesion was based on histological examination and/or clinical and radiological follow-up.

Time between initial diagnosis of malignancy and detection of the hepatic nodule ranged from 4.5 to 13.5 years (mean 8.5 years) with majority of the malignancy being neuroblastoma (80%) treated by high dose chemotherapy and hematopoietic stem cell transplantation with or without local radiation. A total of 43 nodules was detected, often multiple (9/15) and small (mean size 1.3 cm). All nodules demonstrated prominent enhancement on the arterial phase and were isointense or slightly hyperintense on the delayed phase. Most of the lesions were isointense or slightly hyperintense on T2-weighted image and isointense or slightly hypointense on T1- weighted image. A central scar was seen in four patients. Additionally, hepatic hemosiderosis was noted in four (27%), in whom all the lesions were hyperintense on both T1- and T2- weighted images.

Benign hypervascular hepatic nodules can occur, especially in the survivors of childhood malignancy who received high dose chemotherapy and hematopoietic stem cell transplantation. They are frequently multiple and small. Dynamic MR seems to be helpful in differentiating hepatic nodules presented in these patients and, can be diagnostic in typical cases of FNH.

Dynamic MR is helpful in differentiating hypervascular hepatic nodules developed in the childhood cancer survivors.

Yoo, S, Jeon, T, Kim, J, Eo, H, Dynamic MR Imaging Findings and Clinical Features of Benign Hypervascular Hepatic Nodule in Childhood Cancer Survivors.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12029907.html