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

Abstract

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.

Spontaneous Rupture of a Hepatic Adenoma: Diagnostic Nuances and the Necessity of Followup

“…Although the pathophysiology of FNH is not fully understood, a proposed mechanism is that the tumor arises from locally disturbed blood flow, which subsequently causes a hyperplastic, polyclonal response in normal hepatocytes as a result of either hypoxia or hyperperfusion [ 3 ]. Though the role of OCs in FNH is not clear, OCs may contribute to the growth of the tumor [ 4 ].…”

Focal Nodular Hyperplasia: A Comprehensive Review with a Particular Focus on Pathogenesis and Complications

“… 7 Sarma et al . 7 documented two cases of FNH diagnosed based on imaging in women who had regression in size over a 4-year and 7-year course after stopping OCPs. Of note, one of the cases had Cowden syndrome, which is known to be associated with increased risk of many tumors.…”

“…5,6 There have been many cases reporting association with use of OCPs and FNH as well as regression of FNH after discontinuation of these medications. 7 Sarma et al 7 documented two cases of FNH diagnosed based on imaging in women who had regression in size over a 4-year and 7-year course after stopping OCPs. Of note, one of the cases had Cowden syndrome, which is known to be associated with increased risk of many tumors.…”