Focal nodular hyperplasia after oxaliplatin-based chemotherapy: A diagnostic challenge ☆

Radiology Case Reports

article

Lorenzo Vassallo¹  Mirella Fasciano¹  Mirella Fortunato¹  Giulio Fraternali Orcioni¹  Tiziana Vavala'¹  Daniele Regge¹ 

[1]Department of Radiology, S.S. Annunziata Hospital

关键词: Focal nodular hyperplasia;    Metastases;    Liver;    Oxaliplatin;    Magnetic resonance imaging;    Gadoxetic acid;   

DOI  :  10.1016/j.radcr.2022.03.020

学科分类：生物化学工程

来源: University of Washington * Department of Radiology

【 摘 要 】

Chemotherapy could induce benign liver alterations presenting as diffuse or focal lesions mimicking metastases . Oxaliplatin-induced vascular liver injury is described in literature, but the association with FNH-like lesions has been reported in a limited number of cases. We herewith describe the case of a 67-year-old male, who had laparoscopic right-sided hemicolectomy , 8 years ago, because of colonic adenocarcinoma (pT3N0M0) and subsequent adjuvant chemotherapy (capecitabine + oxaliplatin), who referred to the ultrasound service of our Radiology Unit because of abdominal pain. Five-years follow-up was negative for metastases. Ultrasound examination showed 2 small hypoechoic hepatic nodules, in segment VIII and VII, confirmed at CT , suspected for metastases. FDG-PET was negative, and blood tumor markers were within normal ranges. For further evaluation we performed gadoxetic acid (Gd-EOB-DTPA)-enhanced MRI that showed hyperintensity of the nodules in the hepatobiliary phase with central small hypointensity due to a central scar. Considering the previous oxaliplatin-based chemotherapy the findings were compatible with FNHlike lesions and the diagnostic suspicion was confirmed at ultrasound-guided core needle biopsy . Knowledge of the possible occurrence of FNH-like lesions in oncologic setting, along with the detection of typical MRI appearance, is important for appropriate management and may avoid unnecessary biopsy or surgery and reduce patients’ anxiety.

【 授权许可】

CC BY|CC BY-NC-ND