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

Autor: Lorenzo Vassallo, MD, Mirella Fasciano, MD, Mirella Fortunato, MD, Giulio Fraternali Orcioni, MD, Tiziana Vavala', MD, Daniele Regge, MD
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Radiology Case Reports, Vol 17, Iss 6, Pp 1858-1865 (2022)
Druh dokumentu: article
ISSN: 1930-0433
DOI: 10.1016/j.radcr.2022.03.020
Popis: 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.
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