Coexistence of focal nodular hyperplasia and pseudotumor caused by focal spared lesion in the liver of a young man

Abstract

We report a case of 19-year-old male with an underlying case of chronic hepatitis C infection who suffered from two types of benign liver tumor: focal nodular hyperplasia (FNH) and pseudotumor due to focal fatty spared area in a fatty liver. These two kinds of lesions rarely occur simultaneously. The spectral Doppler ultrasound (US) images of these lesions were also provided. We suggest that spectral Doppler US provides an alternative diagnostic tool for the differentiation of liver tumors regarding their vascular pattern, which might help ensure a correct diagnosis.

Findings and Implications of Focal Fatty Sparing of the Liver at Follow‐up

“…The findings of this study imply that if a hypoechoic region in fatty liver is not appreciable at follow‐up, it may be focal fatty sparing or a pseudolesion rather than a true lesion. If a hypoechoic lesion and focal fatty sparing coexist in fatty liver, 21 , 22 the focal fatty sparing may not be appreciable over time, whereas the true tumor cannot disappear.…”

Focal Nodular Hyperplasia (FNH) of the Liver

“…Multiple FNH have been observed to occur in conjunction with hepatic leiomyosarcoma with epithelioid features (Iordanidis et al 2002), the FNH lesions proposed to have been emerged owing to abnormal hepatic blood supply. The coexistence of FNH and hepatic focal fatty change producing so-called pseudotumor has been reported (Wu et al 2003). FNH has been observed in association with familial glioblastoma (Everson and Fraumeni 1976).…”