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| Atypical focal nodular hyperplasia of the liver |
| Muhammad Rizwan Khan, Taimur Saleem, Tanveer Ul Haq and Kanwal Aftab |
Karachi, Pakistan
Author Affiliations: Section of General Surgery, Department of Surgery (Khan MR), Section of Interventional Radiology, Department of Radiology (Haq TU), and Department of Pathology (Aftab K), Aga Khan University Hospital; Medical College (Saleem T), Aga Khan University, Stadium Road, Karachi 74800, Pakistan
Corresponding Author: Muhammad Rizwan Khan, MBBS, FCPS, FRCS, Section of General Surgery, Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi 74800, Pakistan (Tel: 92-21-4930051; Fax: 92-21-4934294; Email: khan.rizwan@aku.edu) |
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Abstract BACKGROUND: Focal nodular hyperplasia, a benign hepatic tumor, is usually asymptomatic. However, rarely the entity can cause symptoms, mandating intervention.
METHOD: We present a case of focal nodular hyperplasia of the liver, which caused a considerable diagnostic dilemma due to its atypical presentation.
RESULTS: A 29-year-old woman presented with a 15-year history of a progressively increasing mass in the right upper quadrant which was associated with pain and emesis. Examination showed a firm, mobile mass palpable below the right subcostal margin. A computed tomography scan of the abdomen showed an exophytic mass arising from hepatic segments III and IVb. Trucut biopsy of the hepatic mass was equivocal. Angiography showed a vascular tumor that was supplied by a tortuous branch of the proper hepatic artery. Surgical intervention for removal of the mass was undertaken. Intra-operatively, two large discrete tumors were found and completely resected. Histopathological examination showed features consistent with focal nodular hyperplasia.
CONCLUSION: This description of an unusual case of focal nodular hyperplasia of the liver highlights the point that the diagnosis of otherwise benign hepatic tumors may be difficult despite extensive work-up in some cases.
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2011, Vol. 10 
