Focal nodular hyperplasia and hepatic adenoma: current diagnosis and management

Abstract

Benign liver tumors are common lesions that can be classified into cystic and solid lesions. Cystic lesions are the most frequent; however, they rarely represent a diagnostic or therapeutic challenge. In contrast, solid lesions are more difficult to characterize and management remains controversial. The wide availability and use of advanced imaging modalities, including ultrasonography, computed tomography, and magnetic resonance imaging have led to increased identification of incidental liver masses. Although some of these incidentally discovered masses are malignant, most are benign and must be included in the differential diagnosis. In this article we review FNH and HA. Its etiology, biological behavior, diagnosis, and treatment will be highlighted.

National trends in the use of surgery for benign hepatic tumors in the United States

“…Possible explanations include increased detection of benign lesions with the ubiquitous use of cross-sectional imaging, as well as the proliferation of the MIS approach to hepatopancreatobiliary (HPB) surgery. 2,27 Other investigators have suggested that the increasing acceptance of laparoscopy may, in part, explain the increase use of the operative approach for benign liver tumors. 45 For example, in a review by Toro et al, 42 the authors reported that laparoscopy had increased the use of hepatic resection for benign liver tumors.…”

Oestrogen hormone receptors in focal nodular hyperplasia

“…Although FNH is traditionally associated with a very low to no incidence of complications, scattered reports suggest that complications of FNH such as rupture and bleeding do occur, although much less frequently than in the context of hepatic adenoma . Albeit that the majority of patients with FNH are asymptomatic and are managed conservatively with observation, patients who develop abdominal pain, marked tumour enlargement or have atypical imaging findings may require surgery . On follow‐up, up to 13% of patients who are under surveillance for FNH go on to develop protracted symptoms .…”

“…Hence, it is imperative that the surgeon who diagnoses the patient with FNH is able to give sound advice on OCP use. Several contemporary reports recommend the cessation of OCPs in patients with FNH …”

A Controversial Case of a Double Hepatic Incidentaloma in a Male Patient with Kidney Failure

“…Benign hepatic lesions are found in 20-50% of cases [2][3]. The Hepatocellular Adenoma (HCA) is a rare benign tumor that develops in non-cirrhotic patients.…”

“…Usually, it's a single and variable size mass located in the right lobe in the subcapsular. Histologically, it's characterized by the loss of normal lobular hepatic architecture cords of normal or slightly atypical hepatocytes, with high glycogen and fat content in absence of bile ducts and Kupffer cells and often intratumoral haemorrhage [2].…”