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Case Reports
. 2019 Jul 30:20:1124-1127.
doi: 10.12659/AJCR.916398.

Fluctuation of Hepatic Focal Nodular Hyperplasia Size with Oral Contraceptives Use

Susumu Fukahori  1   2 , Tetsuya Kawano  1   3 , Yasushi Obase  1 , Yasuhiro Umeyama  1   2 , Nanae Sugasaki  1   2 , Akitoshi Kinoshita  1   2 , Chizu Fukushima  1 , Masaki Yamakawa  4 , Katsuhisa Omagari  5 , Hiroshi Mukae  1
Affiliations
Case Reports

Fluctuation of Hepatic Focal Nodular Hyperplasia Size with Oral Contraceptives Use

Susumu Fukahori et al. Am J Case Rep. .

Abstract

BACKGROUND Focal nodular hyperplasia (FNH) of the liver is a rare benign nodular lesion that arises in women of reproductive age. Although a role of female hormones has been suggested, their influence on the course of FNH has remained controversial. CASE REPORT A 44-year-old woman with a 12-year history of oral contraceptive use was referred to our hospital for examination of an asymptomatic liver mass (3 cm in diameter) identified by computed tomography. We diagnosed FNH using imaging methods and fine-needle biopsy. Oral contraceptives were discontinued because the mass increased over a period of 21 months. Four months later, the mass had decreased in size, indicating that FNH can spontaneously regress when oral contraceptives are discontinued. CONCLUSIONS Discontinuation of oral contraceptives use can reduce the size of FNH, as in this case.

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Conflict of interest statement

Conflict of interest: None declared

Conflicts of interest

None.

Figures

Figure 1.
Figure 1.
Arterial phase computed tomography (CT) image shows obvious hyper-attenuation of mass with a central scar.
Figure 2.
Figure 2.
Unenhanced T2-weighted magnetic resonance (MR) image (A) shows slightly elevated signal intensity in peripheral portion of mass. Before (B) and after (C) superparamagnetic iron oxide (SPIO)-enhanced T2-weighted MRI. Signal intensity of mass is obviously decreased.
Figure 3.
Figure 3.
Tc-99 m-sulphur colloid scintigraphy shows high liver uptake.
Figure 4.
Figure 4.
Microphotograph of liver biopsy specimen. Liver tissue is composed of normal hepatocytes and Kupffer cells, but radial arrangement of liver cell trabeculae and lobular architecture are absent. Central scar composed of fibrous tissue, thick-walled artery, and proliferating bile ductules is evident at peripheral portion of specimen. HE staining, ×120.
Figure 5.
Figure 5.
Changes in size of FNH mass during follow-up of this case. Patient continued OC for 2 years after the first visit (A) to our hospital, and OC was stopped 2 years after the first visit (B). The diameter of FNH lesion increased from 2 cm (A) to 3 cm (B). The diameter of the FNH mass decreased from 3 cm (B) to 2.5 cm (C) 4 months after she stopped taking OC.
See this image and copyright information in PMC

References

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