Ann Hepatobiliary Pancreat Surg.  2019 Feb;23(1):8-12. 10.14701/ahbps.2019.23.1.8.

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

• Jung JM
• Hwang S
• Kim KH
• Ahn CS
• Moon DB
• Ha TY
• Song GW
• Jung DH

• KMID: 2439040
• DOI: http://doi.org/10.14701/ahbps.2019.23.1.8

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.

Keyword

Hepatectomy; Benign disease; Premalignant lesion

MeSH Terms

Adenoma, Liver Cell
Adult*
Biopsy
Focal Nodular Hyperplasia*
Hemangiosarcoma
Hepatectomy
Humans
Liver*
Plasmacytoma
Uncertainty

Figure

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  Fig. 1 Preoperative imaging and operative findings of a 58 year-old male patient showing focal nodular hyperplasia (FNH) with an angiosarcoma component. Computed tomography (A: arterial phase and B: portal phase) and magnetic resonance imaging (C) suggested FNH or adenoma. Percutaneous biopsy suggested angiosarcoma. The pathological examination of the resected specimen (D) revealed a final diagnosis of FNH, with multifocal well-differentiated adenosarcoma.

• 

  Fig. 2 Preoperative imaging and operative findings of a 31 yearold male patient showing large focal nodular hyperplasia (FNH). Computed tomography (A: arterial phase and B: portal phase) and magnetic resonance imaging (C) suggested FNH. The pathological examination of the resected specimen (D) revealed a final diagnosis of FNH.

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