Regression of Focal Nodular Hyperplasia of the Liver After Oral Contraceptive Discontinuation

Côté, Christian

doi:10.1097/00003072-199709000-00001

Cited by 17 publications

(3 citation statements)

References 16 publications

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“…Extensive sectioning of the liver at autopsy in the area of the previous FNH revealed fibrous scar tissue. Although uncommon, FNH regression has been reported 14, 15…”

Section: Discussionmentioning

confidence: 99%

Abdominal compression: A new intraoperative maneuver to detect chyle fistulas during left neck dissections that include level IV

et al. 2012

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To our knowledge, this is the first description of a specific maneuver to actively detect a lymphatic fistula at the end of a left neck dissection involving level IV. In this study, intraoperative abdominal compression was able to detect an open lymphatic vessel in 6.3% of the cases, as well as to assure its effective sealing in the remaining 93.7% of the patients. Moreover, no life-threatening high-volume fistula was noted in this study.

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“…Extensive sectioning of the liver at autopsy in the area of the previous FNH revealed fibrous scar tissue. Although uncommon, FNH regression has been reported 14, 15…”

Section: Discussionmentioning

confidence: 99%

Abdominal compression: A new intraoperative maneuver to detect chyle fistulas during left neck dissections that include level IV

et al. 2012

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“…Since the 1970s, many cases of FNH have been reported in patients taking both high- and low-dose OCPs. Some authors have suggested that OCPs are not the pathophysiologic cause of FNH (as in hepatic adenoma) ( 1 ); however, the correlation between regression of FNH lesions and the discontinuation of OCPs in several cases have suggested that exogenous estrogens may act as trophic agents ( 8 , 16 , 17 , 18 , 19 , 20 , 21 ). Some groups have argued that FNH may regress spontaneously, regardless of patients’ OCP use or endogenous hormonal status ( 10 , 13 , 14 , 22 , 23 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

“…Some groups have argued that FNH may regress spontaneously, regardless of patients’ OCP use or endogenous hormonal status ( 10 , 13 , 14 , 22 , 23 , 24 ). Others have posited that there is a direct association between OCP use and FNH ( 15 ), and that withdrawal of OCPs may lead to its regression ( 12 , 17 , 18 , 19 , 20 ). Several groups have reported data on the natural history of FNH, the highlights of which are summarized in Table 1.…”

Section: Discussionmentioning

confidence: 99%

Two cases of near-complete regression of focal nodular hyperplasia of the liver: Case reports and review of the literature

Sarma¹,

Shaaban²,

Heilbrun³

et al. 2012

Radiology Case Reports

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While regression of focal nodular hyperplasia of the liver is not uncommon, reports of near-complete involution or regression of these lesions are rare. We report two cases of focal nodular hyperplasia that underwent near-complete regression—one in a 27-year-old female that regressed over a period of 4 years, and one in a 46-year-old female that regressed over a 7-year period. Both patients discontinued use of exogenous estrogens between the diagnosis of focal nodular hyperplasia and its subsequent regression. Although contemporary cross-sectional imaging has improved the ability to detect and follow these lesions, few studies examining the natural history of focal nodular hyperplasia have been conducted. We discuss pertinent imaging findings on magnetic resonance imaging and computed tomography, and review the literature on regression of focal nodular hyperplasia and the effects of endogenous hormones and exogenous hormone therapy.

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Focal nodular hyperplasia after orthotopic liver transplantation

2009

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Focal nodular hyperplasia (FNH) has been well characterized in native livers, but to our knowledge, no cases of FNH have been described in liver allografts. We review the clinicopathological features of 6 FNHs identified in 4 patients after orthotopic liver transplantation. There were 3 male patients and 1 female patient ranging in age from 2 to 63 years. The time from transplant to a diagnosis of FNH ranged from 15 to 118 months. Two patients presented with an incidental solitary liver nodule. One patient presented with 2 liver nodules, and the other patient initially presented with 1 liver nodule and was found to have another nodule at autopsy 6 years later. Two FNHs were seen as an incidental finding at autopsy, and the other 4 were initially identified on ultrasound. Follow-up magnetic resonance imaging and computed tomography scans revealed features atypical for FNH and suspicious for hepatocellular carcinoma. The initial diagnosis of FNH was made by needle core biopsy in 3 cases and at autopsy in 2 cases. The lesions ranged in size from 1.7 to 6.9 cm. Three patients had conditions associated with altered hepatic vascular perfusion; 2 patients had portal vein thrombosis, and 1 had a partial allograft from a living donor. In conclusion, FNH can present as a hepatic nodule after orthotopic liver transplantation and should not be confused with hepatocellular carcinoma. Because of altered hepatic circulation in the posttransplant liver, a diagnosis of FNH would not be unexpected. 1-8 Hepatocellular carcinoma may be recurrent or de novo in patients with the known risk factors for this condition, especially recurrent viral hepatitis. Nodular regenerative hyperplasia is believed to represent hyperplastic growth of hepatocytes in response to abnormalities of hepatic blood flow.Similarly, focal nodular hyperplasia (FNH) is also thought to arise as a hyperplastic response to vascular abnormalities. Because alterations of hepatic vascular perfusion are frequent after liver transplantation, it would not be surprising to encounter FNH in a transplanted liver. However, a review of the literature did not reveal any cases of FNH arising within a transplanted liver. We herein review 4 cases and discuss the clinicopathological findings. PATIENTS AND METHODSThe cases were retrieved from the surgical pathology files of the University of California Los Angeles Center for the Health Sciences. Clinical, radiological, and follow-up information were obtained from reviews of the medical records. The surgical specimens were fixed in 10% buffered formalin, and sections were routinely processed and embedded in paraffin. Serial 4-m-thick sections were prepared for routine hematoxylin and eosin staining and histochemical staining.

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Regression of Focal Nodular Hyperplasia of the Liver After Oral Contraceptive Discontinuation

Cited by 17 publications

References 16 publications

Abdominal compression: A new intraoperative maneuver to detect chyle fistulas during left neck dissections that include level IV

Abdominal compression: A new intraoperative maneuver to detect chyle fistulas during left neck dissections that include level IV

Two cases of near-complete regression of focal nodular hyperplasia of the liver: Case reports and review of the literature

Focal nodular hyperplasia after orthotopic liver transplantation

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