Long-term follow-up of focal nodular hyperplasia of the liver

Atypical hepatic focal nodular hyperplasia presenting as acute abdomen and misdiagnosed as hepatocellular carcinoma

“…FNH is usually asymptomatic with no malignant potential, and usually discovered incidentally at laparotomy or noted during the work‐up of unrelated symptoms. Complications such as rupture and bleeding are extremely rare and only several cases have existed, this leads to the general recommendation that observation of FNH is safe and, once the diagnosis is certain, conservative management is the best choice and surgical resection is needed only in doubtful cases or in symptomatic patients 6,25 …”

“…Complications such as rupture and bleeding are extremely rare and only several cases have existed, this Hepatology Research 2007; 37: [1100][1101][1102][1103][1104][1105] Atypical FNH presenting as acute abdomen 1103 leads to the general recommendation that observation of FNH is safe and, once the diagnosis is certain, conservative management is the best choice and surgical resection is needed only in doubtful cases or in symptomatic patients. 6,25 Although, since 1975, only five cases of FNH associated with intraperitoneal hemorrhage have been reported 7,10,26-28 in the English literature (five reported cases and our case are listed in Table 1), and four additional cases have been published in German and French literature, [29][30][31] all but one case were reported recently from 2000 to 2006. The recent trend is most likely related to improvements in imaging and diagnostic technology, rather than enhanced awareness on the topic, for, in most reported cases, the possibility of FNH was always neglected until pathological diagnosis was confirmed.…”