Details

Autor(en) / Beteiligte

• Bröker, Mirelle E. E.
• Klompenhouwer, Anne J.
• Gaspersz, Marcia P.
• Alleleyn, Annick M. E.
• Dwarkasing, Roy S.
• Pieters, Indra C.
• de Man, Robert A.
• IJzermans, Jan N. M.

Titel

Growth of Focal Nodular Hyperplasia is Not a Reason for Surgical Intervention, but Patients Should be Referred to a Tertiary Referral Centre

Ist Teil von

• World journal of surgery, 2018-05, Vol.42 (5), p.1506-1513

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2018

Link zum Volltext

Quelle

Wiley Online Library Journals【Remote access available】

Beschreibungen/Notizen

• Background When a liver lesion diagnosed as focal nodular hyperplasia (FNH) increases in size, it may cause doubt about the initial diagnosis. In many cases, additional investigations will follow to exclude hepatocellular adenoma or malignancy. This retrospective cohort study addresses the implications of growth of FNH for clinical management. Methods We included patients diagnosed with FNH based on ≥2 imaging modalities between 2002 and 2015. Characteristics of patients with growing FNH with sequential imaging in a 6-month interval were compared to non-growing FNH. Results Growth was reported in 19/162 (12%) patients, ranging from 21 to 200%. Resection was performed in 4/19 growing FNHs; histological examination confirmed FNH in all patients. In all 15 conservatively treated patients, additional imaging confirmed FNH diagnosis. No adverse outcomes were reported. No differences were found in characteristics and presentation of patients with growing or non-growing FNH. Conclusion This study confirms that FNH may grow significantly without causing symptoms. A significant increase in size should not have any implications on clinical management if confident diagnosis by imaging has been established by a tertiary benign liver multidisciplinary team. Liver biopsy is only indicated in case of doubt after state-of-the-art imaging. Resection is deemed unnecessary if the diagnosis is confirmed by multiple imaging modalities in a tertiary referral centre.