Spontaneous regression of focal nodular hyperplasia of the liver

Abstract

Focal nodular hyperplasia (FNH) of the liver is a rare benign lesion that probably reflects a local hyperplastic response of hepatocytes to a vascular abnormality. Currently, the natural history of the disease remains largely unknown. We present a patient with FNH of the liver who was followed up for 4 years. A 22-year-old woman with a 3-year history of oral contraceptive use was referred to our hospital in September 1996 for further examination of a liver tumor. A diagnosis of FNH was made using various imaging methods, such as ultrasonography, enhanced computed tomography (CT) scanning, MR imaging, and hepatic angiography, as well as fine-needle biopsy. A decrease in the size of the lesion was observed by enhanced CT scanning during the 4-year observation period. In this patient, oral contraceptive use and its discontinuation may have influenced the natural history of FNH. The present case suggests that an accurate diagnosis is of the utmost importance, and a patient with FNH should be managed conservatively rather than by resection, because FNH has the potential for spontaneous regression with the discontinuation of oral contraceptives.

Focal nodular hyperplasia of the liver following hematopoietic SCT

“…The relation between oral contraception and regenerating nodules remains elusive. Data suggest that estrogen induced-FNH reversed by treatment interruption, 16 but these findings have not been confirmed. 17 Other risk factors associated with liver injury following HSCT, such as pre-transplantation abnormal liver enzymes levels and/or HCV (hepatitis C virus)/HBV (hepatitis B virus) positive serologies…”

“…The natural history of FNH is characterized by the absence of complications. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] In our series, 50% of nodules have grown bigger with a median delay of 47 months, but all remained asymptomatic. No malignant transformation has been reported to date, a reassuring fact considering the incidence of second tumors following HSCT.…”

Pathological diagnosis of liver cell adenoma and focal nodular hyperplasia: Bordeaux update

“…6. Little is known concerning the growth and involution of liver nodules (either HCA or FNH), and this aspect deserves further study [32][33][34][35]. A small isolated nodule (measuring a few millimeters) without the characteristic features of classical FNH could be a FNH precursor [15] or a microadenoma [36].…”

Hepatic stellate cells are activated around central scars of focal nodular hyperplasia of the liver—a potential mechanism of central scar formation

“…FNH reflects a hyperplastic response of hepatocytes to the vascular abnormality, but the dynamics of blood supply may differ greatly from case to case. A reported rare case showing spontaneous regression of FNH indicates its complex pathogenesis [29]. The large-sized FNH without a central scar totally lacked HSC activation or the expression of 8-OHdG and iNOS.…”