Pedunculated hepatic focal nodular hyperplasia: A case report and review of the literature

Ismail, Imen Ben; Zenaidi, Hakim; Jouini, Raja; Rebii, Saber; Zoghlami, Ayoub

doi:10.1002/ccr3.4202

Cited by 3 publications

(17 citation statements)

References 14 publications

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“…We experienced FNH in a child who was born following IVF, and we assume that there might be a correlation between IVF and FNH in a healthy child. Identical to the controversial effect of oral contraceptives on FNH, which is still not definite, more investigation is needed to find the possible connection between IVF and FNH [ 8 – 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…(2021) [ 5 ] Male/5 RUQ pain 9 cm × 10 cm × 12 cm Seg 5, 8 Normal US, CT, and MRI Surgery No complications No Ismail et al . 2021 [ 10 ] Female/38 Asymptomatic 4.5 cm × 3.5 cm × 3 cm Seg 3 Normal N/A (detected intraoperatively during surgical repair of hernia) Surgery No recurrence Yes Akaguma et al . (2023) [ 20 ] Female/35 RUQ abdominal pain 7 cm × 7 cm × 5 cm Seg 6 N/A US and CT Surgery No complication Yes OCP oral contraceptives, N/A not answered, Seg segment, US ultrasonography, CT computed tomography, RUQ right upper quadrant, MRI magnetic resonance imaging, CEUS contrast enhanced ultrasound, EUS endoscopic ultrasound, CRP c-reactive protein, WBC white blood cell, AST aspartate aminotransferase, ALT alanine aminotransferase …”

Section: Discussionmentioning

confidence: 99%

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Pedunculated focal nodular hyperplasia of the liver in a healthy child born following in vitro fertilization: a case report and review of the literature

Moayerifar,

Samidoust,

Gholipour

et al. 2024

J Med Case Reports

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Background Focal nodular hyperplasia is a common nonmalignant liver mass. This nonvascular lesion is an uncommon mass in children, especially those with no predisposing factors, namely radiation, chemotherapy, and hematopoietic stem cell therapy. Exophytic growth of the lesion further than the liver margins is not common and can complicate the diagnosis of the lesion. This report observes a focal nodular hyperplasia as a pedunculated lesion in a healthy child. Case presentation We describe a 9-year-old healthy Persian child who was born following in vitro fertilization complaining of abdominal pain lasting for months and palpitation. Employing ultrasound and computed tomography, a mass was detected in the right upper quadrant compatible with focal nodular hyperplasia imaging features. The child underwent surgery and the mass was resected. Conclusion Diagnosing focal nodular hyperplasia, especially pedunculated form can be challenging, although magnetic resonance imaging with scintigraphy is nearly 100% sensitive and specific. Thus, a biopsy may be needed to rule out malignancies in some cases. Deterministic treatment in patients with suspicious mass, remarkable growth of lesion in serial examination, and persistent symptoms, such as pain, is resection, which can be done open or laparoscopic.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pedunculated focal nodular hyperplasia of the liver in a healthy child born following in vitro fertilization: a case report and review of the literature

Moayerifar,

Samidoust,

Gholipour

et al. 2024

J Med Case Reports

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“…To date, several authors have reported pedunculated cases of FNH, while most of them were associated with clinical symptoms that required intervention [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. Recently, Akaguma et al [ 31 ] successfully performed laparoscopic surgery for pedunculated FNH in a female patient during pregnancy due to the increased risk of developing complications and severe clinical manifestations.…”

Section: Current Landscape Of Pedunculated Lesions In Fnhmentioning

confidence: 99%

“…The majority of FNH cases are asymptomatic and usually detected as incidental findings during physical and imaging examinations or surgical procedures. However, pedunculated FNH may sometimes present with acute abdominal pain, dyspepsia, epigastric discomfort, nausea, vomiting or a tender palpable abdominal mass [ 19 , 29 ]. In addition, alpha-fetoprotein (AFP) levels and liver function tests are generally within normal limits [ 10 , 85 ].…”

Section: Clinical Manifestations and Diagnostic Workupmentioning

confidence: 99%

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

Tsalikidis,

Mitsala,

Pappas-Gogos

et al. 2023

JCM

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Focal nodular hyperplasia (FNH) is the second most common benign hepatic tumor and can rarely present as an exophytic solitary mass attached to the liver by a stalk. Most FNH cases are usually detected as incidental findings during surgery, imaging or physical examination and have a high female predominance. However, the pedunculated forms of FNH are particularly rare and commonly associated with severe complications and diagnostic challenges. Hence, our study aims to provide a comprehensive summary of the available data on the pedunculated FNH cases among adults and children. Furthermore, we will highlight the role of different therapeutic options in treating this clinical entity. The use of imaging techniques is considered a significant addition to the diagnostic toolbox. Regarding the optimal treatment strategy, the main indications for surgery were the presence of symptoms, diagnostic uncertainty and increased risk of complications, based on the current literature. Herein, we also propose a management algorithm for patients with suspected FNH lesions. Therefore, a high index of suspicion and awareness of this pathology and its life-threatening complications, as an uncommon etiology of acute abdomen, is of utmost importance in order to achieve better clinical outcomes.

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Benign liver tumours: understanding molecular physiology to adapt clinical management

Nault

Paradis

Ronot

et al. 2022

Nat Rev Gastroenterol Hepatol

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Pedunculated hepatic focal nodular hyperplasia: A case report and review of the literature

Abstract: Focal nodular hyperplasia (FNH) is a common asymptomatic benign hepatic tumor encountered in middle‐aged women. However, pedunculated FNH is exceedingly rare and more frequently associated with complications. That is why surgical management is mandatory in this form.

Cited by 3 publications

References 14 publications

Pedunculated focal nodular hyperplasia of the liver in a healthy child born following in vitro fertilization: a case report and review of the literature

Pedunculated focal nodular hyperplasia of the liver in a healthy child born following in vitro fertilization: a case report and review of the literature

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

Benign liver tumours: understanding molecular physiology to adapt clinical management

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