Hepatocellular Adenoma and Focal Nodular Hyperplasia / 대한내과학회지

Recent advances in imaging technologies have offered us a great chance to detect a variety of focal liver lesions. Accordingly, it is of paramount importance to determine whether these focal liver lesions are malignant or nonmalignant. Some benign hepatic tumors mimicking hepatocellular carcinoma typically develop from either regenerative or dysplastic/neoplastic processes. The most common benign hepatic solid tumors that are not of vascular origin include focal nodular hyperplasia and hepatocellular adenoma. A majority of patients with benign hepatic tumors are often asymptomatic and require no specific treatment. However, surgical resection may be infrequently needed for cases with clinical symptoms or malignant potential. This review will touch on the epidemiology, pathogenesis, clinical features, diagnosis, and management of focal nodular hyperplasia and hepatocellular adenoma.

Clinical Analysis of Focal Nodular Hyperplasia of the Liver in 11 Patients

PURPOSE: The purpose of this study was to determine the clinical features of focal nodular hyperplasia (FNH) and investigate its diagnosis and treatment. METHODS: Eleven patients with FNH treated from January 1997 to January 2007 were analyzed. The clinical findings of pathologically proven FNH were retrospectively reviewed. RESULTS: Among the eleven patients with 18 masses, the mean age was 29.5 (11~57) and the gender ratio (male:female) was 4:7. Four patients had clinical symptoms. Six patients had a solitary mass and five had multiple masses. The mean tumor diameter was 2.73 +/- 1.82 cm. The overall rate of a correct preoperative diagnosis was 0% (0/4) by ultrasound, 36.3% (4/11) by CT and 20.0% (2/10) by MRI. Only two patients had a central stellate scar in the mass. All patients underwent hepatic resection without complication. CONCLUSION: The results of this study showed that the combination of Dynamic CT and dual contrast MRI are important diagnostic methods for FNH. However, a definite preoperative diagnosis of FNH, without a central stellate scar, is very difficult. Surgical resection is recommended for patients with an uncertain diagnosis or clinical symptoms.

A Case of Childhood Multiple Focal Nodular Hyperplasia of the Liver / 대한소아혈액종양학회지

Focal nodular hyperplvasia (FNH) is a rare benign hepatic tumor that likely represents a local hyperplastic response of hepatocytes to a congenital vascular anomaly. FNH is typically asymtomatic and has a benign course. Hepatic resection is performed when the lesions are large, symptomatic and complicated or when the diagnosis remains uncertain. Although many cases of FNH in children have been described to date in other countries, only one Korean case of multiple FNH has been reported on English literature. We recently experienced a rare case of multiple FNH in a 10-year-old boy, that was confirmed by right inferior subsegmentectomy, left lateral segmentectomy and left medial tumorectomy. We report this case with brief review of literature.

Surgical treatment of giant cavernous hemangiomas of the liver: analysis of 7 patients

Seven patients with giant cavernous hemangioma of the liver were treated surgically with success at Pusan Gospel Hospital, Kosin Medical College, Pusan, from 1980 through 1989. They were 3 males and 4 females, and their ages ranged from 6 to 59 years. The tumors were located on the right lobe of the liver in 5 patients and on the left lobe in 2. The lesions were solitary in all patients, and their sizes varied from 4cm to 15cm in diameter. All patients underwent hepatic resection: 1 right hepatic lobectomy and 4 partial resections for tumors on the right lobe, and 1 left lobectomy and 1 left lateral segmentectomy for tumors on the left lobe. There was no surgical death, but 1 patient had a postoperative complication: multiple stress ulcers on the stomach and ileum. The pathologic diagnosis was cavernous hemangioma in all cases. In the long-term follow-up, there was no recurrence of preoperative symptoms in any patient.