Surgical indications for focal nodular hyperplasia of the liver: Single-center experience of 48 adult cases

Abstract

Backgrounds/Aims Focal nodular hyperplasia (FNH) is one of the most common benign tumors of the liver. There is still a lack of evidence on surgical indications for FNH. This study intended to analyze the surgical indications for FNH. Methods We analyzed 48 cases of FNH diagnosed after hepatic resection. Results Common reasons leading to surgical resection were diagnostic uncertainty (n=31), and persistent symptoms (n=8). None of our patients had a past history of contraceptive use. Percutaneous biopsy was performed in 14 patients and FNH was diagnosed in nine patients, and hepatic adenoma, hepatocellular carcinoma, plasmacytoma, angiosarcoma, and atypical hepatocellular proliferation in one patient each. Minor hepatectomy (n=37) was performed more frequently than major hepatectomy (n=11). Open hepatectomy (n=29) was performed more frequently than laparoscopic hepatectomy (n=19), but laparoscopic and minimally-invasive surgery was frequently performed during the late phase of the study period. Postoperative surgical complications occurred in two patients (4.1%). Conclusions FNH can be diagnosed by imaging studies, but surgical treatment may be considered in cases of diagnostic uncertainty or persistent symptoms.

Large focal nodular hyperplasia is unresponsive to arterial embolization: A case report

“…FNH is not a rare disease in the general population but its pathophysiology is still elusive[ 5 ]. In China, FNH is detected in adult men or children, and is solitary in most cases[ 2 , 6 ]. FNH lesions are generally asymptomatic and are therefore discovered fortuitously during autopsy, or imaging examinations for unrelated symptoms.…”

Focal nodular hyperplasia associated with a giant hepatocellular adenoma: A case report and review of literature

“…Therapeutic abstention is usually recommended for asymptomatic patients with a definitive diagnosis[ 11 ]. Surgical management is reserved for symptomatic patients or with diagnosis uncertainty despite a complete workup[ 12 , 13 ]. Twelve cases of spontaneous rupture of FNH are described and considering these extremely rare events, conservative treatment is the actual well-established standard of care [English-language literature until 2019; NCBI.gov with terms “spontaneous; rupture; FNH].…”

Ultrasound-Guided Percutaneous Thermal Ablation of Hepatic Focal Nodular Hyperplasia——A Multicenter Retrospective Study

“…Since FNH is usually asymptomatic and there have been no reports of malignant progression of this disease, conservative observation should be considered first. However, clinical treatment should be considered if the diagnosis is unclear, the patient has symptoms or the lesion becomes enlarged during follow-up ( Perrakis et al, 2017 ; Jung et al, 2019 ).…”