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Case Reports
. 2021 Oct 27;13(10):1450-1458.
doi: 10.4254/wjh.v13.i10.1450.

Focal nodular hyperplasia associated with a giant hepatocellular adenoma: A case report and review of literature

Sérgio Gaspar-Figueiredo  1 , Amaniel Kefleyesus  1 , Christine Sempoux  2 , Emilie Uldry  1 , Nermin Halkic  3
Affiliations
Case Reports

Focal nodular hyperplasia associated with a giant hepatocellular adenoma: A case report and review of literature

Sérgio Gaspar-Figueiredo et al. World J Hepatol. .

Abstract

Background: Focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) are well-known benign liver lesions. Surgical treatment is usually chosen for symptomatic patients, lesions more than 5 cm, and uncertainty of diagnosis.

Case summary: We described the case of a large liver composite tumor in an asymptomatic 34-year-old female under oral contraceptive for 17-years. The imaging work-out described two components in this liver tumor; measuring 6 cm × 6 cm and 14 cm × 12 cm × 6 cm. The multidisciplinary team suggested surgery for this young woman with an unclear HCA diagnosis. She underwent a laparoscopic left liver lobectomy, with an uneventful postoperative course. Final pathological examination confirmed FNH associated with a large HCA. This manuscript aimed to make a literature review of the current management in this particular situation of large simultaneous benign liver tumors.

Conclusion: The simultaneous presence of benign composite liver tumors is rare. This case highlights the management in a multidisciplinary team setting.

Keywords: Case report; Composite tumor; Focal nodular hyperplasia; Hepatocellular adenoma; Liver; Video vignette.

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Conflict of interest statement

Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.

Figures

Figure 1
Figure 1
Pre-operative patient’s supine and stand-up picture – no external signs of tumor.
Figure 2
Figure 2
Preoperative drawing – tumor and liver major vessels’ relationship (credits: Dr. Giulia Piazza). FNH: Focal nodular hyperplasia; HCA: Hepatocellular adenoma.
Figure 3
Figure 3
Ultrasonography with a sagittal view of focal nodular hyperplasia and hepatocellular adenoma. D1: Greater axis length. FNH: Focal nodular hyperplasia; HCA: Hepatocellular adenoma.
Figure 4
Figure 4
Computed tomography late portal phase, with a multiplanar reconstruction of focal nodular hyperplasia and hepatocellular adenoma.
Figure 5
Figure 5
Magnetic resonance imaging – T2 sequence. Orange arrow: Focal nodular hyperplasia; White arrow: Hepatocellular adenoma.
Figure 6
Figure 6
Anatomopathological pictures (top: fresh sample; bottom: formalin-fixed sample), sagittal section plane. Yellow arrow: Focal nodular hyperplasia; Green arrow: Hepatocellular adenoma; Orange arrow: Left liver (segment II).
See this image and copyright information in PMC

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