Guzkowy ogniskowy przerost wątroby u dzieci – leczenie chirurgiczne

*Barbara Antoniak¹, Krzysztof Ebinger¹, Anna Piotrowska¹, Teresa Dudek-Warchoł¹, Jadwiga Małdyk², Andrzej Kamiński¹

Summary
Introduction. Focal nodular hyperplasia (FNH) in children, is a relatively rare, tumor-like lesion of the liver, most frequently detected incidentally by ultrasonography. Small tumors require only oncological control, without surgical treatment. Large size of the tumor, its intensive growth and not clearly confirmed histological specimen are indications for surgical resection of the lesion.
Aim. The aim of the study is to analyze clinical data and outcome of five patients treated for FNH.
Material and methods. From January 2005 to December 2012, 5 children with FNH (4 girls and 1 boy), aged 2-17 years, were hospitalized in the Department of Children Surgery, Medical University of Warsaw. The tumor was discovered accidentally in all cases. The patients’ plasma level of the alpha-fetoprotein (AFP) was within normal limits. The tumor was localized in the 3rd segment of the liver in two and in the 4th segment in one patient. Two remaining lesions occurred in two segments each (first in 2nd and 3rd, second in 7th and 8th segment). The diameter of the lesion ranged from 5-10 centimeters. All patients were qualified for surgery. The postoperative histological specimens confirmed FNH. The medical records of those patients were analyzed retrospectively.
Results. Postoperative period was complicated in 1 patient by a biliary fistula, which was successfully operated 6 days after initial intervention. Follow up period ranged from 3 to 6 years. Results of the laboratory tests and radiological studies were correct in all patients.
Conclusions. 1. Indication for surgical treatment of FNH was size of the tumor in four and localization of the lesion in one patient. 2. The tumor had a form of a single mass and its complete resection was surgically possible in the all cases. 3. The radiological studies didn’t reveal recurrence of the disease during a few year follow up period.

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