Alessandro Furlan1, Giuseppe Brancatelli2, Marco Dioguardi Burgio3, Luigi Grazioli4, Jeong Min Lee5,6, Elena Murmura7, Olivier Lucidarme8, Christiane Strauss9, Agnes Rode10, Maxime Ronot3, Valerie Vilgrain3. 1. 1 Department of Radiology, University of Pittsburgh, UPMC Presbyterian, Ste 201, East Wing, 200 Lothrop St, Pittsburgh, PA 15213. 2. 2 Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy. 3. 3 Radiology Department, Beaujon Hospital, University Hospitals Paris Nord Val de Seine, Assistance Publique-Hôpitaux de Paris, Clichy, France. 4. 4 Department of Radiology, Spedali Civili di Brescia, Brescia, Italy. 5. 5 Department of Radiology, Seoul National University Hospital, Seoul, Korea. 6. 6 Department of Radiology, Seoul National University College of Medicine, Seoul, Korea. 7. 7 ASP di Agrigento, Ospedali Civili Riuniti di Sciacca, Sciacca, Italy. 8. 8 Laboratoire d'Imagerie Biomédicale, Hôpital Pitié-Salpêtrière, UPMC Univ Paris 06, CNRS, INSERM, AP-HP, Sorbonne Universités, Paris, France. 9. 9 Service d'Imagerie, Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, France. 10. 10 Service de Radiologie, Hôpital de la Croix-Rousse, Lyon, France.
Abstract
OBJECTIVE: Benign hepatic lesions may occur after chemotherapy treatment and may mimic metastases at imaging. We describe focal nodular hyperplasia (FNH) lesions diagnosed at MRI that occurred de novo after treatment with oxaliplatin. MATERIALS AND METHODS: This is a multiinstitutional case series. We report 14 adult patients with cancer (eight men and six women) with a history of treatment with oxaliplatin and development of new hepatic lesions diagnosed as FNH at pathologic analysis or MRI or both. Imaging and pathology features of the included lesions, the interval since chemotherapy, and the temporal evolution were reviewed. RESULTS: The mean interval between the completion of oxaliplatin treatment and the identification of new hepatic FNH at imaging was 47.6 months. In seven of 14 (50%) patients, the index lesion was diagnosed at pathologic analysis (biopsy or resection) as FNH. In the remaining seven cases, the diagnosis was based on highly accurate MRI features (e.g., hyper- or isointensity of the lesion on hepatobiliary phase images). Lesion growth or occurrence of new lesions was present in 75% of patients at imaging follow-up. CONCLUSION: FNH lesions can occur de novo after treatment with oxaliplatin. Recognizing the typical MRI appearance of these lesions may avoid unnecessary biopsy or surgery and reduce patients' anxiety.
OBJECTIVE:Benign hepatic lesions may occur after chemotherapy treatment and may mimic metastases at imaging. We describe focal nodular hyperplasia (FNH) lesions diagnosed at MRI that occurred de novo after treatment with oxaliplatin. MATERIALS AND METHODS: This is a multiinstitutional case series. We report 14 adult patients with cancer (eight men and six women) with a history of treatment with oxaliplatin and development of new hepatic lesions diagnosed as FNH at pathologic analysis or MRI or both. Imaging and pathology features of the included lesions, the interval since chemotherapy, and the temporal evolution were reviewed. RESULTS: The mean interval between the completion of oxaliplatin treatment and the identification of new hepatic FNH at imaging was 47.6 months. In seven of 14 (50%) patients, the index lesion was diagnosed at pathologic analysis (biopsy or resection) as FNH. In the remaining seven cases, the diagnosis was based on highly accurate MRI features (e.g., hyper- or isointensity of the lesion on hepatobiliary phase images). Lesion growth or occurrence of new lesions was present in 75% of patients at imaging follow-up. CONCLUSION: FNH lesions can occur de novo after treatment with oxaliplatin. Recognizing the typical MRI appearance of these lesions may avoid unnecessary biopsy or surgery and reduce patients' anxiety.
Authors: Roberto Cannella; Adele Taibbi; Salvatore Pardo; Giuseppe Lo Re; Ludovico La Grutta; Tommaso Vincenzo Bartolotta Journal: BJR Open Date: 2019-04-29