Solitary liver nodules

Abstract

There has been confusion in the literature over the nomenclature of solitary liver nodules. Several such lesions have recently been reported in patients taking oral contraceptives. Similarities exist between these cases that suggest they may be examples of focal nodular hyperplasia. Here three further cases are presented. The criteria for making the diagnosis and its importance are discussed.

PIP: This article, reporting 3 case studies of solitary liver nodules, focuses on the discrepancy in the medical literature among various nomenclatures used to describe hepatic lesions and tumors. Case 1 was a 5-year-old girl with an upper abdominal mass; case 2 was a 19-year-old woman, with a 4-month history of contraceptive use, with a hamartoma which was resected; case 3 was a 38-year-old woman, with a 5-year history of oral contraceptive use and a hysterectomized uterus, who presented with abdominal pain 5 years post-hysterectomy. She had a nodule which was biopsied but not resected. All 3 cases, though from dissimilar patient populations, reflected characteristics of focal nodular hyperplasia, and all were reparative in nature. Histologically and vascularly, these nodules appear to be developed from a vascular basis, and the association of these nodules with oral contraceptive use encourages such speculation. Arguments for diagnosing these liver tumors as focal nodular hyperplasia are presented.