Abstract
Focal nodular hyperplasia (FNH) is a benign tumorlike condition of the liver with no known potential for malignant transformation. FNH accounts for approximately 8 % of all primary hepatic tumors and is the second most common benign liver tumor after hemangioma. FNH is in most of cases an asymptomatic incidental finding. The stability in size of most FNH lesions, the lack of potential for malignant transformation, and the extremely low risk of rupture and hemorrhage support a conservative approach for management of most patients with radiologically convincing or histologically proven FNH. When symptoms occur, in patients in with the diagnosis is not clear and if there is the evidence of progressive growth surgery should be considered.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Nguyen BN, Flejou JF, Terris B, Belghiti J, Degott C (1999) Focal nodular hyperplasia of the liver: a comprehensive pathologic study of 305 lesions and recognition of new histologic forms. Am J Surg Pathol 23(12):1441–1454
Luciani A, Kobeiter H, Maison P, Cherqui D, Zafrani ES, Dhumeaux D et al (2002) Focal nodular hyperplasia of the liver in men: is presentation the same in men and women? Gut 50(6):877–880
Wanless IR, Mawdsley C, Adams R (1985) On the pathogenesis of focal nodular hyperplasia of the liver. Hepatology 5(6):1194–1200
Rebouissou S, Bioulac-Sage P, Zucman-Rossi J (2008) Molecular pathogenesis of focal nodular hyperplasia and hepatocellular adenoma. J Hepatol 48(1):163–170
Vilgrain V (2006) Focal nodular hyperplasia. Eur J Radiol 58(2):236–245
Bioulac-Sage P, Rebouissou S, Sa Cunha A, Jeannot E, Lepreux S, Blanc JF et al (2005) Clinical, morphologic, and molecular features defining so-called telangiectatic focal nodular hyperplasias of the liver. Gastroenterology 128(5):1211–1218
Klatskin G (1977) Hepatic tumors: possible relationship to use of oral contraceptives. Gastroenterology 73(2):386–394
Mathieu D, Kobeiter H, Maison P, Rahmouni A, Cherqui D, Zafrani ES et al (2000) Oral contraceptive use and focal nodular hyperplasia of the liver. Gastroenterology 118(3):560–564
Rifai K, Mix H, Krusche S, Potthoff A, Manns MP, Gebel MJ (2013) No evidence of substantial growth progression or complications of large focal nodular hyperplasia during pregnancy. Scand J Gastroenterol 48(1):88–92
Bouyn CI, Leclere J, Raimondo G, Le Pointe HD, Couanet D, Valteau-Couanet D et al (2003) Hepatic focal nodular hyperplasia in children previously treated for a solid tumor. Incidence, risk factors, and outcome. Cancer 97(12):3107–3113
Murray CP, Yoo SJ, Babyn PS (2003) Congenital extrahepatic portosystemic shunts. Pediatr Radiol 33(9):614–620
Buscarini E, Danesino C, Plauchu H, de Fazio C, Olivieri C, Brambilla G et al (2004) High prevalence of hepatic focal nodular hyperplasia in subjects with hereditary hemorrhagic telangiectasia. Ultrasound Med Biol 30(9):1089–1097
Halankar JA, Kim TK, Jang HJ, Khalili K, Masoom HA (2012) Understanding the natural history of focal nodular hyperplasia in the liver with MRI. Indian J Radiol Imaging 22(2):116–120
Eris C, Yildiz MK, Odabasi M, Akbulut S, Abuoglu H, Ozkan E (2013) Gastric outlet obstruction caused by focal nodular hyperplasia of the liver: a case report and literature review. Int J Surg Case Rep 4(8):681–683
Demarco MP, Shen P, Bradley RF, Levine EA (2006) Intraperitoneal hemorrhage in a patient with hepatic focal nodular hyperplasia. Am Surg 72(6):555–559
Cherqui D, Rahmouni A, Charlotte F, Boulahdour H, Métreau JM, Meignan M et al (1995) Management of focal nodular hyperplasia and hepatocellular adenoma in young women: a series of 41 patients with clinical, radiological, and pathological correlations. Hepatology 22(6):1674–1681
Gaiani S, Piscaglia F, Serra C, Bolondi L (1999) Hemodynamics in focal nodular hyperplasia. J Hepatol 31(3):576
Carlson SK, Johnson CD, Bender CE, Welch TJ (2000) CT of focal nodular hyperplasia of the liver. AJR Am J Roentgenol 174(3):705–712
Brancatelli G, Federle MP, Grazioli L, Blachar A, Peterson MS, Thaete L (2001) Focal nodular hyperplasia: CT findings with emphasis on multiphasic helical CT in 78 patients. Radiology 219(1):61–68
Buetow PC, Pantongrag-Brown L, Buck JL, Ros PR, Goodman ZD (1996) Focal nodular hyperplasia of the liver: radiologic-pathologic correlation. Radiographics 16(2):369–388
Mortelé KJ, Praet M, Van Vlierberghe H, Kunnen M, Ros PR (2000) CT and MR imaging findings in focal nodular hyperplasia of the liver: radiologic-pathologic correlation. AJR Am J Roentgenol 175(3):687–692
Grazioli L, Morana G, Federle MP, Brancatelli G, Testoni M, Kirchin MA et al (2001) Focal nodular hyperplasia: morphologic and functional information from MR imaging with gadobenate dimeglumine. Radiology 221(3):731–739
Blachar A, Federle MP, Ferris JV, Lacomis JM, Waltz JS, Armfield DR (2002) Radiologists’ performance in the diagnosis of liver tumors with central scars by using specific CT criteria. Radiology 223(2):532–539
Makhlouf HR, Abdul-Al HM, Goodman ZD (2005) Diagnosis of focal nodular hyperplasia of the liver by needle biopsy. Hum Pathol 36(11):1210–1216
Fabre A, Audet P, Vilgrain V, Nguyen BN, Valla D, Belghiti J et al (2002) Histologic scoring of liver biopsy in focal nodular hyperplasia with atypical presentation. Hepatology 35(2):414–420
Vilgrain V, Fléjou JF, Arrivé L, Belghiti J, Najmark D, Menu Y et al (1992) Focal nodular hyperplasia of the liver: MR imaging and pathologic correlation in 37 patients. Radiology 184(3):699–703
Herman P, Pugliese V, Machado MA, Montagnini AL, Salem MZ, Bacchella T et al (2000) Hepatic adenoma and focal nodular hyperplasia: differential diagnosis and treatment. World J Surg 24(3):372–376
Kuo YH, Wang JH, Lu SN, Hung CH, Wei YC, Hu TH et al (2009) Natural course of hepatic focal nodular hyperplasia: a long-term follow-up study with sonography. J Clin Ultrasound 37(3):132–137
Chang SK, Chung YF, Thng CH, Loo HW (2005) Focal nodular hyperplasia presenting as acute abdomen. Singapore Med J 46(2):90–92
Bathe OF, Mies C, Franceschi D, Casillas J, Livingstone AS (2003) Massive hemorrhage and infarction complicating focal nodular hyperplasia of the liver. HPB (Oxford) 5(2):123–126
Hyder O, Pulitano C, Firoozmand A, Dodson R, Wolfgang CL, Choti MA et al (2013) A risk model to predict 90-day mortality among patients undergoing hepatic resection. J Am Coll Surg 216(6):1049–1056
Poon RT, Fan ST, Lo CM, Liu CL, Lam CM, Yuen WK et al (2004) Improving perioperative outcome expands the role of hepatectomy in management of benign and malignant hepatobiliary diseases: analysis of 1222 consecutive patients from a prospective database. Ann Surg 240(4):698–708
Jarnagin WR, Gonen M, Fong Y, DeMatteo RP, Ben-Porat L, Little S et al (2002) Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg 236(4):397–406
Ardito F, Tayar C, Laurent A, Karoui M, Loriau J, Cherqui D (2007) Laparoscopic liver resection for benign disease. Arch Surg 142(12):1188–1193
Gagner M, Rheault M, Dubuc J (1992) Laparoscopic partial hepatectomy for liver tumor. Surg Endosc 6:99
Azagra JS, Goergen M, Gilbart E, Jacobs D (1996) Laparoscopic anatomical (hepatic) left lateral segmentectomy-technical aspects. Surg Endosc 10(7):758–761
Gigot JF, Hubert C, Banice R, Kendrick ML (2004) Laparoscopic management of benign liver diseases: where are we? HPB (Oxford) 6(4):197–212
Nguyen KT, Gamblin TC, Geller DA (2009) World review of laparoscopic liver resection-2,804 patients. Ann Surg 250(5):831–841
Gómez GarcÃa MP, Cruz González I, Peña Baranda B, AtÃn del Campo VM, Méndez MartÃn JJ (2014) Treatment of symptomatic focal nodular hyperplasia by arterial embolization. Cir Esp 92(2):135–137
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing AG Switzerland
About this chapter
Cite this chapter
Pinotti, E. et al. (2015). Focal Nodular Hyperplasia. In: Aldrighetti, L., Cetta, F., Ferla, G. (eds) Benign Tumors of the Liver. Springer, Cham. https://doi.org/10.1007/978-3-319-12985-3_12
Download citation
DOI: https://doi.org/10.1007/978-3-319-12985-3_12
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-12984-6
Online ISBN: 978-3-319-12985-3
eBook Packages: MedicineMedicine (R0)