Large focal nodular hyperplasia of the liver treated with transcatheter arterial embolization and laparoscopic resection: A case report

Abstract

Focal nodular hyperplasia (FNH) is a rare benign hepatic tumor which is frequently observed in women of reproductive age, and therapeutic intervention needs to be considered in cases wherein the tumor has a risk of rupture. The laparoscopic approach is beneficial, especially for young women, but is often challenging because the tumor is large and hemorrhagic. Herein, we report a case of large FNH in a 22‐year‐old woman. The patient was asymptomatic; however, the tumor was approximately 15 cm in diameter and protruded from the liver. Given the risk of rupture, we decided to perform surgical resection. Preoperative transcatheter arterial embolization led to rapid shrinkage of the tumor and control of intraoperative bleeding, which enabled us to safely perform laparoscopic liver resection. The combination of surgical resection with intravascular embolization may be a promising therapeutic option for hypervascular tumors such as FNH.

Pedunculated Focal Nodular Hyperplasia: When in Doubt, Should We Cut It Out?

“…The authors recommended considering this possible association in treatment decision-making. Other authors supported the combination of a preoperative TAE procedure with surgery as a safe and effective treatment option for large asymptomatic lesions, given the potential risk of FNH complications [ 131 ].…”