Background & objective: Focal nodular hyperplasia (FNH) is a rare benign hepatic tumor, and its diagnosis and treatment remain controversial. This study was to summarize the clinical features of FNH, and explore its diagnosis and treatment principles.
Methods: Clinical data of 38 FNH patients, treated in our hospital from Jul. 1997 to Jul. 2004, were studied retrospectively with literature review to summarize the clinical feature, diagnosis, and treatment of FNH. All the patients were followed up till Jul. 2004.
Results: Among the 38 patients, 30 (78.9%) were under 40 years old, 26 (68.4%) were asymptomatic, 32 (84.2%) had normal liver function, and alpha fetoprotein (AFP) was negative in all the patients. Correct diagnosis rates were 5.3% (2/38) for B ultrasonography, 45.5% (5/11) for color Doppler ultrasound, 100% (2/2) for contrast-enhanced ultrasound, and 36.8% (14/34) for double-phase helical CT scan. Of the 38 patients, 34 (89.5%) underwent hepatic resection without any complication, 1 underwent biopsy and transcatheter arterial embolization (TAE), 2 underwent biopsy and percutaneous ethanol injection (PEI), 1 only underwent biopsy. The size of lesions didn't change after TAE or PEI. HCC appeared in 2 patients with hepatitis 69 and 32 months after the resection of FNH lesions. At the end of follow-up, 37 patients were survival, and the other one died of other disease 1 year after PEI.
Conclusions: The patients with FNH usually have no clinical symptoms with good prognosis. The combination of multiple imaging measures is of help to the diagnosis of FNH. We recommend close observation for patients with confirmed diagnosis of FNH and without clinical symptoms, and recommend surgical resection for those with equivocal diagnosis, symptoms, lesion enlargement, or accompanied with hepatitis or cirrhosis.