Focal Nodular Hyperplasia in a Young Male as an Incidental Finding Associated With Acute Lithiasic Chronic Cholecystitis. Case Report and Literature Review

Focal nodular hyperplasia (FNH) is considered the second most frequent benign liver tumor with a low prevalence, with a broad predominance in the female population. Most cases are asymptomatic and are often discovered incidentally. Diagnostic imaging through MRI, CT, and ultrasound can be achieved in up to 80% of cases. In some cases, a histopathological study may be necessary, especially in view of the diagnostic uncertainty and suspicion of malignancy. To date, the management of these lesions remains controversial, conservative management is recommended for asymptomatic or small lesions, relegating surgical treatment only in cases of symptomatic lesions or uncertain behavior.

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A benign liver tumor mimics hepatic metastasis from colon cancer

Asian Biomedicine ◽

10.2478/abm-2010-0057 ◽

2010 ◽

Vol 4 (3) ◽

pp. 463-467

Author(s):

Napa Parinyanitikul ◽

Laddawan Vajragupta ◽

Naruemon Klaikaew ◽

Boonchoo Sirichindakul ◽

Virote Sriuranpong

Keyword(s):

Colon Cancer ◽

Liver Metastasis ◽

Liver Tumor ◽

Focal Nodular Hyperplasia ◽

Whole Body ◽

Sigmoid Colon Cancer ◽

Term Survival ◽

Benign Liver Tumor ◽

Nodular Hyperplasia ◽

Benign Liver

Abstract Background: Liver is the most common distant metastasized organ in advanced colon cancer. Surgical resection of metastatic lesions would offer the best chance of a long-term survival. An accurate diagnosis and evaluation of extent of disease is crucial in the management of liver metastasis. Objective: Report a benign hepatic condition mimicking liver metastasis in a colon cancer patient. Case presentation: A 53-year-old male with an early stage sigmoid colon cancer was treated with sigmoidectomy followed by adjuvant chemotherapy consisting of 5-FU, leucovorin, and oxaliplatin for six months. Annual computerized tomography of abdomen at two years after the surgery revealed three hypervascular nodules in the liver. Investigations including MRI of the liver and whole body FDG-F18 PET/CT demonstrated evidence consistent with non-metastatic liver nodules. Liver biopsy of one of the lesions led to the diagnosis of “focal nodular hyperplasia”. Conclusion: The possible etiology, diagnosis, and further management of this benign liver tumor, the focal nodular hyperplasia became clear.

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Intraperitoneal Hemorrhage in a Patient with Hepatic Focal Nodular Hyperplasia

The American Surgeon ◽

10.1177/000313480607200620 ◽

2006 ◽

Vol 72 (6) ◽

pp. 555-559 ◽

Cited By ~ 5

Author(s):

Mario P. Demarco ◽

Perry Shen ◽

Robert F. Bradley ◽

Edward A. Levine

Keyword(s):

Surgical Resection ◽

Focal Nodular Hyperplasia ◽

Benign Lesion ◽

Hepatic Adenoma ◽

Traditional Management ◽

Intraperitoneal Hemorrhage ◽

Benign Liver Tumor ◽

Nodular Hyperplasia ◽

Benign Liver ◽

Benign Course

Focal nodular hyperplasia (FNH) is a common benign liver tumor that is often confused with hepatic adenoma. Despite the benign course of both lesions, hepatic adenomas are associated with rupture and bleeding, and suggested management often includes prophylactic surgical resection. FNH lesions are thought to not rupture or bleed, and traditional management does not include resection. We report the case of a woman with FNH who presented with intraperitoneal hemorrhage after the rupture of a FNH lesion. Only six previous documented cases of hemoperitoneum associated with FNH have ever been reported. This report reviews all previously recorded cases of FNH lesions that have resulted in intraperitoneal hemorrhage. We suggest that although FNH is a benign lesion and intervention is typically unnecessary, the potential for rupture requiring surgical resection should always be considered.

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Radiographic characteristics of benign liver tumors: Focal nodular hyperplasia and hepatic adenoma

Radiographics ◽

10.1148/radiographics.5.4.673 ◽

1985 ◽

Vol 5 (4) ◽

pp. 673-682 ◽

Cited By ~ 10

Author(s):

Timothy J. Welch ◽

Patrick F. Sheedy ◽

C. Michael Johnson ◽

David H. Stephens ◽

J. William Charboneau ◽

...

Keyword(s):

Focal Nodular Hyperplasia ◽

Liver Tumors ◽

Hepatic Adenoma ◽

Benign Liver Tumors ◽

Nodular Hyperplasia ◽

Benign Liver

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Paediatric focal nodular hyperplasia: A case study of typical contrast-enhanced ultrasound findings with quantitative analysis and correlated with magnetic resonance imaging

Ultrasound ◽

10.1177/1742271x20947760 ◽

2020 ◽

pp. 1742271X2094776

Author(s):

Andreas Panayiotou ◽

Vasileios Rafailidis ◽

Annamaria Deganello ◽

Maria Sellars ◽

Paul S Sidhu

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Focal Nodular Hyperplasia ◽

Ultrasound Examination ◽

Liver Lesion ◽

Contrast Enhanced Ultrasound ◽

Resonance Imaging ◽

Contrast Enhanced ◽

Nodular Hyperplasia ◽

Benign Liver

Introduction Focal nodular hyperplasia, a benign liver tumour, is the second most common focal benign liver lesion, after a cavernous haemangioma. Contrast-enhanced ultrasound is used increasingly for the diagnostic work up and follow-up of focal liver lesions in adults, but is particularly valuable in the paediatric population, with the ability to reduce radiation and the nephrotoxic contrast agents used in computed tomography or magnetic resonance imaging. Confident recognition of focal nodular hyperplasia is important; it is benign, usually asymptomatic, of no clinical significance, of no clinical consequence or malignant potential. We present a case of focal nodular hyperplasia of the liver with its characteristic findings on conventional ultrasound, contrast-enhanced ultrasound with quantitative analysis and correlated with magnetic resonance imaging. Case presentation: A 15-year-old female with right upper quadrant abdominal pain was referred for liver ultrasound. A focal liver lesion was detected on B-mode ultrasound examination, and colour Doppler demonstrated no specific features. Contrast-enhanced ultrasound examination demonstrated early arterial enhancement, with a characteristic spoke-wheel pattern, centrifugal uniform filling of the lesion on the late arterial phase and sustained enhancement on the portal venous phase. Quantitative contrast-enhanced ultrasound has been performed, showing a typical curve of enhancement, as well as characteristic parametric images, supporting the interpretation of contrast-enhanced ultrasound and assisting the diagnosis. Magnetic resonance imaging demonstrated a central T2 hyperintense scar and similar enhancement characteristics as contrast-enhanced ultrasound on T1 gadolinium-enhanced sequences. Conclusion Contrast-enhanced ultrasound is a useful technique for the differentiation of benign from malignant liver lesions and has the potential to establish the diagnosis of focal nodular hyperplasia, based on the enhancement pattern, which is similar to that observed on magnetic resonance imaging but can be better appreciated with superior temporal, contrast and spatial resolution of contrast-enhanced ultrasound.

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A case of giant focal nodular hyperplasia of the liver in young male

Kanzo ◽

10.2957/kanzo.20.868 ◽

1979 ◽

Vol 20 (8) ◽

pp. 868-876 ◽

Cited By ~ 1

Author(s):

Kazuhiro HIROHASHI ◽

Hiroaki KINOSHITA ◽

Yuhei TSUDA ◽

Kunio OHMORI ◽

Takio NARUYAMA ◽

...

Keyword(s):

Focal Nodular Hyperplasia ◽

Young Male ◽

Nodular Hyperplasia

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A young male patient with nonB-nonC hepatocellular carcinoma and concomitant focal nodular hyperplasia developed in the normal liver

Kanzo ◽

10.2957/kanzo.48.233 ◽

2007 ◽

Vol 48 (5) ◽

pp. 233-239

Author(s):

Yasuhito Kubo ◽

Mariko Itubo ◽

Kazuhiko Koike ◽

Atushi Hokari ◽

Hisao Tajiri ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Male Patient ◽

Focal Nodular Hyperplasia ◽

Young Male ◽

Normal Liver ◽

Nodular Hyperplasia

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Pure Uterine Lipoma and Focal Nodular Hyperplasia of the Liver: Concurrence of a Rare Tumor and Another Incidental Finding

Case Reports in Pathology ◽

10.1155/2020/8891820 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Mohammad Hossein Anbardar ◽

Neda Soleimani ◽

Seyed Ali Malek-Hosseini ◽

Shirin Moradmand

Keyword(s):

Focal Nodular Hyperplasia ◽

Incidental Finding ◽

Left Lobe ◽

Uterine Neoplasms ◽

Uterine Tumors ◽

Nodular Hyperplasia ◽

Radiologic Investigation ◽

Magnetic Resonance Imaging Mri ◽

Abnormal Vaginal Bleeding ◽

Uterine Lipoma

Background. Fatty uterine tumors, especially pure uterine lipoma, are very rare, but clinically and radiologically, they can mimic other primary benign and malignant uterine neoplasms. Case Report. A multipara 61-year-old postmenopausal woman presented with abnormal vaginal bleeding for 3 months. Assessment by ultrasound and magnetic resonance imaging (MRI) revealed a hyperechoic mass in the uterine corpus. Furthermore, during radiologic investigation, there was an incidental isoechoic mass in the left lobe of the liver. Pure uterine lipoma and hepatic focal nodular hyperplasia were diagnosed. Conclusion. Pure lipoma of the uterus, even though rare, has to be kept in the differential diagnosis of uterine neoplasms, especially in postmenopausal women. Till now, just a few concurrent tumors have been reported with pure uterine lipoma, and among them, FNH is the first extragenital tumor.

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Benign Hepatocellular Tumors in Children: Focal Nodular Hyperplasia and Hepatocellular Adenoma

International Journal of Hepatology ◽

10.1155/2013/215064 ◽

2013 ◽

Vol 2013 ◽

pp. 1-11 ◽

Cited By ~ 27

Author(s):

Stéphanie Franchi-Abella ◽

Sophie Branchereau

Keyword(s):

Focal Nodular Hyperplasia ◽

Liver Tumors ◽

Hepatocellular Adenoma ◽

Predisposing Factors ◽

Type I ◽

Predisposing Factor ◽

Androgen Therapy ◽

Nodular Hyperplasia ◽

Benign Liver

Benign liver tumors are very rare in children. Most focal nodular hyperplasia (FNH) remain sporadic, but predisposing factors exist, as follows: long-term cancer survivor (with an increasing incidence), portal deprivation in congenital or surgical portosystemic shunt. The aspect is atypical on imaging in two-thirds of cases. Biopsy of the tumor and the nontumoral liver is then required. Surgical resection will be discussed in the case of large tumors with or without symptoms. In the case of associated vascular disorder with portal deprivation, restoration of the portal flow will be discussed in the hope of seeing the involution of FNH. HepatoCellular Adenoma (HCA) is frequently associated with predisposing factors such as GSD type I and III, Fanconi anemia especially if androgen therapy is administered, CPSS, and SPSS. Adenomatosis has been reported in germline mutation of HNF1-α. Management will depend on the presence of a predisposing factor and may include metabolic control, androgen therapy withdrawn, or closure of the shunt when appropriate. Surgery is usually performed on large lesions. In the case of adenomatosis or multiple lesions, surgery will be adapted. Close followup is required in all cases.

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