Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2015; 21(3): 1028-1031
Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.1028
Focal nodular hyperplasia coexistent with hepatoblastoma in a 36-d-old infant
Ying Gong, Lian Chen, Zhong-Wei Qiao, Yang-Yang Ma
Ying Gong, Zhong-Wei Qiao, Department of Radiology, Children’s Hospital of Fudan University, Shanghai 201102, China
Lian Chen, Yang-Yang Ma, Department of Pathology, Children’s Hospital of Fudan University, Shanghai 201102, China
Author contributions: Gong Y and Qiao ZW analyzed the CT imaging and wrote the paper; Chen L and Ma YY contributed to the interpretation of histopathologic data.
Supported by National Key Clinical Specialty Construction Programs of China (2014-2016); and Medical Guide Project of Shanghai Municipal Science and Technology Commission, No. 134119a4100 (to Qiao ZW).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Zhong-Wei Qiao, MD, PhD, Department of Radiology, Children’s Hospital of Fudan University, 399 WanYuan Road, Shanghai 201102, China. zqiao@fudan.edu.cn
Telephone: +86-21-64931802 Fax: +86-21-64931901
Received: April 26, 2014
Peer-review started: April 30, 2014
First decision: June 10, 2014
Revised: July 3, 2014
Accepted: September 5, 2014
Article in press: September 5, 2014
Published online: January 21, 2015
Processing time: 269 Days and 4.1 Hours
Abstract

Focal nodular hyperplasia (FNH) is a benign hepatic tumor characterized by hepatocyte hyperplasia and a central stellate scar. The association of FNH with other hepatic lesions, such as adenomas, hemangiomas and hepatocellular carcinoma, has been previously reported, but FNH associated with another hepatic tumor is rare in infants. Here we report a case of FNH coexistent with hepatoblastoma in a 36-d-old girl. Computed tomography (CT) imaging showed an ill-delineated, inhomogeneous enhanced mass with a central star-like scar in the right lobe of the liver. The tumor showed early mild enhancement at the arterial phase (from 40HU without contrast to 52HU at the arterial phase), intense enhancement at the portal phase (87.7HU) and 98.1HU in the 3-min delay scan. A central scar in the tumor presented as low density on non-contrast CT and slightly enhanced at delayed contrast-enhanced scanning. This infant underwent surgical resection of the tumor. Histopathology demonstrated typical FNH coexistent with a focal hepatoblastoma, which showed epithelioid tumor cells separated by proliferated fibrous tissue.

Keywords: Focal nodular hyperplasia; Hepatoblastoma; Infant; Computed tomography

Core tip: Focal nodular hyperplasia (FNH) is infrequent in infants, and hepatoblastoma is the most common primary malignant liver tumor in infants. The case reported here was a 36-d-old girl suffering from FNH coexistent with hepatoblastoma. Computed tomography imaging showed an ill-delineated, inhomogeneous enhanced mass with a central star-like scar in the right lobe of the liver. The patient underwent surgical resection of the tumor, and histopathology demonstrated typical FNH coexistent with a focal hepatoblastoma.