Focal nodular hyperplasia of the liver: Two clinical case reports with an atypical presentation
Keywords:
Focal nodular hyperplasia, oral contraceptivesAbstract
Focal nodular hyperplasia of the liver (FNH) usually presents as
a solitary, benign, asymptomatic lesion in the female sex. The
authors present two cases of FNH. A 27-year-old man presented
with a slight liver enzyme increase on routine blood analysis. Ultrasonography, CT and MRI were performed and showed a solitary
mass in the left hepatic lobe, characteristic of FNH. The patient
was followed up over seven years. He became progressively
symptomatic with epigastric pain and postprandial fullness and
underwent surgical resection which resulted in symptomatic relief.
The other case is a 42-year-old female, who had been taking oral
contraceptives, with three hepatic masses seen ultrasonically on a
liver scan performed to investigate unspecific abdominal pain. MRI
confirmed the diagnosis of FNH. The patient has been followed-up
for two years and remains asymptomatic.
The authors decided to present these cases because of their
atypical features. In the first one: it is unusual to make a diagnosis
of FNH in male patients and cases are rarely symptomatic with
the need for surgical resection. In the second one: multiple lesions
are rare. The controversial question of the association between
oral contraceptives and FNH is raised.
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