What is focal nodular hyperplasia of the liver?
Focal nodular hyperplasia (FNH) is a benign tumor of the liver and is the second most common tumor of the liver after the benign liver tumor known as hemangioma. FNH does not turn into liver cancer and generally it does not grow in size, spread or bleed, and in most people it does not produce any symptoms.
Is Focal nodular hyperplasia fatty liver?
The arterial blood in FNH, as opposed to that in adenomas, flows centrifugally from the anomalous central arteries. Approximately 50% of lesions show some degree of fatty infiltration, as opposed to the surrounding liver, which shows signs of steatosis in less than 20% of classic FNH lesions.
Can FNH be misdiagnosed?
Risk of misdiagnosis is high with FNH liver lesions. They are most commonly mistaken as hepatic adenoma liver lesions or intrahepatic cholangiocarcinoma. An accurate diagnosis is critical to avoid unnecessary biopsy, surgery, or other invasive treatment methods.
What does focal nodular hyperplasia look like?
Typical FNH Macroscopically, typical lesions demonstrate a mass which is often quite large with well-circumscribed margins but poorly encapsulated. A characteristic feature is a prominent central scar with radiating fibrous septa, but this is present in less than 50% of cases 7.
How is focal nodular hyperplasia of the liver treated?
Traditionally, open or laparoscopic resection of FNH (associated or not with hepatic artery ligation) has been advocated as the preferred curative treatment in the case of changes in clinic, radiological or clinicoradiological characteristics (1-5, 7-20).
Does focal nodular hyperplasia go away?
Although a large FNH is often associated with significant symptoms, almost all tumors remain stable in size and do not develop complications, such as hemorrhage and rupture. Therefore, FNH usually requires no treatment or surveillance if the diagnosis is well established [4, 5].
Can FNH cause symptoms?
Clinically, FNH are asymptomatic in 80%–90% of cases, which are generally incidental findings. Symptoms are characterized by abdominal pain of varying intensity, depending on the size and situation of the lesion.
Can FNH grow radiology?
Conclusion. This study confirms that FNH may grow significantly without causing symptoms. A significant increase in size should not have any implications on clinical management if confident diagnosis by imaging has been established by a tertiary benign liver multidisciplinary team.
Does FNH cause pain?
In conclusion, FNH is a benign lesion of the liver that can cause pain that is associated with the increase in size of the lesion. Surgical resection is usually performed for persistent pain or for lesions that are suspicious on radiological and pathological investigations.
How is focal nodular hyperplasia treated?
Surgery to treat focal nodular hyperplasia If the FNH is large, surgeons may remove the tumor. In partial hepatectomy surgery, or resection, surgeons extract the tumor and a small part of the tissue around it.
