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Hepatic pseudotumor in long‐standing biliary atresia patients undergoing liver transplantation
Author(s) -
Liu YuehWei,
Concejero Allan M.,
Chen ChaoLong,
Cheng YuFan,
Eng HockLiew,
Huang TungLiang,
Chen TaiYi,
Wang ChihChi,
Wang ShihHo,
Lin ChihChe,
Yong CheeChien,
Yang ChinHsiang,
Jordan Amornetta P.,
Jawan Bruno
Publication year - 2007
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21320
Subject(s) - medicine , biliary atresia , radiology , magnetic resonance imaging , liver transplantation , lesion , nodule (geology) , inflammatory pseudotumor , transplantation , differential diagnosis , pathology , surgery , paleontology , biology
A pseudotumor, giant regenerative nodule, or macroregenerative nodule is an unusual benign hepatic lesion in biliary atresia (BA) patients. This tumor may mimic malignant transformation and may preclude liver transplantation (LT). The clinical and imaging surveillance of patients after the Kasai procedure is therefore an important aspect of management of BA patients. Our objective is to report our experience and describe the incidence, imaging, and pathologic features of pseudotumors in BA patients awaiting LT. From August 1990 to December 2006, 133 LTs for BA were performed. Five (3.8%; 4 female, 1 male) patients were diagnosed with pseudotumor. The patients' records were reviewed. The diagnostic imaging modalities used were abdominal ultrasound (US), computed tomography (CT) scan, and magnetic resonance imaging (MRI). Histologic confirmation of the lesions was obtained in all cases. All underwent the Kasai operation in early infancy. Six of 7 lesions in 4 of 5 patients were demonstrated by pretransplant imaging. Two of 7 tumors were detected by US. Five of 7 lesions were detected by CT, and 5 of 7 lesions were demonstrated by MRI. In 1 patient, the lesion was not seen in the US, CT, or MRI but was found during surgery and confirmed by histology. An additional tumor was found incidentally during histologic examination in a patient previously diagnosed to have 2 tumors by CT and MRI. In another patient diagnosed to have 2 tumors on imaging, pathology revealed only a single tumor. In conclusion, although unusual, pseudotumor should be included in the differential diagnosis of liver masses in BA children. Liver Transpt 13: 1545–1551. 2007. © 2007 AASLD.