Focal Nodular Hyperplasia in a Young Male as an Incidental Finding Associated With Acute Lithiasic Chronic Cholecystitis. Case Report and Literature Review
José J. Gómez-Ramos, María G. Ascencio-Rodríguez, Alejandro Marín-Medina, Moises Alejandro Alatorre Jimenez, Vickramjeet Johal, Eduardo Esteban-Zubero
Abstract
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.
Keywords
References
1. Geller SA, de Campos FPF. Focal nodular hyperplasia of the liver. Autops Case Rep 2014;4:5-8.
2. Shen YH, Fan J, Wu ZQ, Ma ZC, Zhou XD, Zhou J, Qiu SJ, et al. Focal nodular hyperplasia of the liver in 86 patients. Hepatobiliary Pancreat Dis Int 2007;6:52-7.
3. Maillette de Buy Wenniger L, Terpstra V, Beuers U. Focal nodular hyperplasia and hepatic adenoma: epidemiology and pathology. Dig Surg 2010;27:24-31.
4. Nguyen BN, Fléjou JF, Terris B, Belghiti J, Degott C. Focal nodular hyperplasia of the liver: a comprehensive pathologic study of 305 lesions and recognition of new histologic forms. Am J Surg Pathol 1999;23:1441-54.
5. Roncalli M, Sciarra A, Tommaso LD. Benign hepatocellular nodules of healthy liver: focal nodular hyperplasia and hepatocellular adenoma. Clin Mol Hepatol 2016;22:199-211.
6. Kondo F. Focal nodular hyperplasia of the liver: Controversy over etiology. J Gastroenterol Hepatol 2000;15:1229-31.
7. Scalori A, Tavani A, Gallus S, La Vecchia C, Colombo M. Oral contraceptives and the risk of focal nodular hyperplasia of the liver: a case-control study. Am J Obstet Gynecol 2002;186:195-7.
8. Scalori A, Tavani A, Gallus S, La Vecchia C, Colombo M. Risk factors for focal nodular hyperplasia of the liver: an Italian case-control study. Am J Gastroenterol 2002;97:2371-3.
9. Mathieu D, Kobeiter H, Maison P, Rahmouni A, Cherqui D, Zafrani ES, Dhumeaux D. Oral contraceptive use and focal nodular hyperplasia of the liver. Gastroenterology 2000;118:560-4.
10. Rebouissou S, Bioulac-Sage P, Zucman-Rossi J. Molecular pathogenesis of focal nodular hiperplasia and hepatocellular adenoma. J Hepatol 2008;48:163-70.
11. Perrakis A, Vassos N, Grützmann R, Croner RS. What is Changing in Indications and Treatment of Focal Nodular Hyperplasia of the Liver. Is There Any Place for Surgery? Ann Hepatol 2017;16:333-341.
12. Nahm CB, Ng K, Lockie P, Samra JS, Hugh TJ. Focal nodular hyperplasia--a review of myths and truths. J Gastrointest Surg 2011;15:2275-83.
13. Venturi A, Piscaglia F, Vidili G, Flori S, Righini R, Golfieri R, Bolondi L. Diagnosis and management of hepatic focal nodular hyperplasia. J Ultrasound 2007;10:116-27.
14. Choi BY, Nguyen MH. The diagnosis and management of benign hepatic tumors. J Clin Gastroenterol 2005;39:401-12.
15. Buetow PC, Pantongrag-Brown L, Buck JL, Ros PR, Goodman ZD. Focal nodular hyperplasia of the liver: radiologic-pathologic correlation. Radiographics 1996;16:369-88.
16. Mortelé KJ, Praet M, Van Vlierberghe H, Kunnen M, Ros PR. CT and MR imaging findings in focal nodular hyperplasia of the liver: radiologic-pathologic correlation. AJR Am J Roentgenol 2000;175:687-92.
17. Balabaud C, Al-Rabih WR, Chen PJ, Evason K, Ferrell L, Hernandez-Prera JC, Huang SF, et al. Focal Nodular Hyperplasia and Hepatocellular Adenoma around the World Viewed through the Scope of the Immunopathological Classification. Int J Hepatol 2013;2013:268625.
18. Balabaud C, Al-Rabih WR, Chen PJ, Evason K, Ferrell L, et al. Focal Nodular Hyperplasia and Hepatocellular Adenoma around the World Viewed through the Scope of the Immunopathological Classification. Int J Hepatol 2013;2013:268625.
19. Krishna, M. Role of Special Stains in Diagnostic Liver Pathology. Clinical Liver Disease 2013;2:S8-S10.
20. Buetow PC, Pantongrag-Brown L, Buck JL, Ros PR, Goodman ZD. Focal nodular hyperplasia of the liver: radiologic-pathologic correlation. Radiographics 1996;16:369-88.
21. Navarro AP, Gomez D, Lamb CM, Brooks A, Cameron IC. Focal nodular hyperplasia: a review of current indications for and outcomes of hepatic resection. HPB (Oxford) 2014;16:503-11. doi: 10.1111/hpb.12169.
Submitted date:
09/01/2019
Reviewed date:
09/10/2019
Accepted date:
09/18/2019
Publication date:
09/19/2019
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email