Radiofrequency ablation of a large hepatic adenoma in a child

doi:10.1016/j.jpedsurg.2013.04.007

Journal of Pediatric Surgery

Volume 48, Issue 6, June 2013, Pages e19-e22

https://doi.org/10.1016/j.jpedsurg.2013.04.007 Get rights and content

Abstract

Hepatic adenomas are rare benign liver tumors seen most commonly in young women on oral contraceptives. Large hepatic adenomas are at risk of malignant transformation and require treatment in select patients, usually by surgical resection. Radiofrequency ablation (RFA) has become a widely used and accepted tool for the curative treatment of small primary hepatocellular carcinomas in adults; however, its use in the treatment of other liver lesions, such as hepatic adenoma, has only recently been described. Use of RFA for liver lesions in pediatric population remains novel. We present a case of large hepatic adenoma successfully treated with RFA in a child with chronic liver disease secondary to alpha-1-antitrypsin deficiency. RFA may be an attractive option in pediatric liver tumor management in selected cases because of its less invasive characteristics.

Section snippets

Case presentation

IRB approval is not required for performing RFA at our institute and for publication of case reports. An 11-year old boy with chronic liver disease secondary to alpha-1-antitrypsin deficiency was found to have a 3 cm mass in the right hepatic lobe on screening abdominal ultrasound. He had well compensated liver function (Child–Pugh Class A, Pediatric End-Stage Liver Disease (PELD) score of − 6), but also had evidence of portal hypertension and hypersplenism. Abdominal MRI 2 months later

Discussion

RFA is used as an alternative to surgical resection in adults with small HCC’s (< 3 cm) arising in the context of chronic liver disease or as a bridge to liver transplantation. The major advantage of RFA is potential decrease in morbidity and mortality, while achieving similar long term survival [2], [3], [7]. Although the role of RFA in management of small HCC’s in adults has been well established, its role in management of benign liver tumors like adenoma has only been recently described.

Conclusion

RFA is a useful treatment alternative in the management of selected cases of hepatic adenoma in children where surgical intervention carries significant risk, providing another tool in the arsenal of managing liver tumors. Performing percutaneous RFA of posterosuperior liver lesion during laparoscopy can be technically challenging.

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There are more references available in the full text version of this article.

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Radiofrequency ablation of a large hepatic adenoma in a child

Abstract

Section snippets

Case presentation

Discussion

Conclusion

J Vasc Interv Radiol

J Pediatr Surg

J Pediatr Surg

Liver cell adenoma: a multicenter analysis of risk factors for rupture and malignancy

Ann Surg Oncol