Stephen W. Chung, Kristin M. DeGirolamo
Focal nodular hyperplasia (FNH) is one of the three most common benign solid liver tumours along with hemangiomas and adenomas. FNH is considered a vascular abnormality that usually follows an uneventful course after accidental discovery on CT or MRI for an unrelated medical problem and rarely requires any treatment. These lesions are stable in nature with minimal risk of rupture and essentially no risk for malignant degeneration. The general recommendations for an asymptomatic FNH are observation only, regardless of size of the mass. However, the consequences of a ruptured liver mass can be very serious as abdominal bleeding may be catastrophic, so accurate diagnosis is essential.1 Here we present the only known case of a patient with multiple FNH nodules and subsequent rupture of two of the lesions; the first treated with a left hepatectomy and the second with embolization. A discussion of the management of the ruptured tumours follows and highlights how little evidence is available for the treatment of multiple ruptures of FNH or for properly risk stratifying patients.
- Choi B, Nguyen M. The diagnosis and management of benign hepatic tumors. J Clin Gastroenterol 2005 May/June;39(5):401–12.
KEYWORDS: focal nodular hyperplasia; ruptured tumor; liver resection; radiofrequency ablation
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Chung SW, DeGirolamo KM. Focal Nodular Hyperplasia: A Case Report of Rare Multiple Ruptures of a Common Liver Tumour in a Single Patient. UBCMJ. 2011 3(1):40-42.