Hypervascular hepatic nodules in childhood cancer survivors: clinical and imaging features.
OBJECTIVE
The aim was to review the clinical and imaging features of hypervascular hepatic nodule (HHN) in childhood cancer survivors.


METHODS
We retrospectively reviewed 11 pediatric patients (female:male, 7:4; age range, 4.0-12.3 years) who had HHNs detected by surveillance computed tomography (CT) after treatment of a malignant solid tumor and subsequently followed by serial imaging without evidence of recurrent malignancy. The lesions were analyzed in terms of number, size, location, CT and ultrasonographic (US) features, and changes in background liver. In addition, clinical features were investigated along with follow-up changes of HHNs by imaging monitoring.


RESULTS
Time between initial diagnosis of malignancy and HHN occurrence ranged from 3.2 to 8.5 years (median, 5.8 years). Ten patients had received high-dose chemotherapy and autologous stem cell transplantation for advanced neuroblastoma. A total of 22 nodules were detected, being multiple in six patients and measuring 0.5-3.0 cm in size. At sequential postcontrast CT, nodules demonstrated moderate to strong enhancement during the earlier phase and were isoattenuated during the later phase. On US, they appeared as hypo- or isoechoic lesions. During follow-up, 11 nodules (50%) regressed, 6 (27%) progressed, and 5 (23%) remained stable. Additional HHNs were noted in four patients during follow-up.


CONCLUSIONS
Childhood cancer survivors are at risk of developing HHNs, which are often multiple and small, years after completing chemotherapy. They are nonaggressive and tend to have a benign course, making conservative management reasonable.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Mi Hee
MH
Lee
So-Young
SY
Yoo
Ji Hye
JH
Kim
Hong
H
Eo
Tae Yeon
TY
Jeon
Seong Hyun
SH
Kim
Eun Young
EY
Ko
Hye-Kyung
HK
Yoon
Ki Woong
KW
Sung
Soo Hyun
SH
Lee
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000556:secondary; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009447:Neuroblastoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D033581:Stem Cell Transplantation / Q000379:methods; D017741:Survivors; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014182:Transplantation, Autologous; D018084:Ultrasonography, Interventional / Q000379:methods*