20 May 2003 : Review article
Med Sci Monit 2003; 9(2): 27-30 :: ID: 15305
Among 27 patients with FNH treated surgically from January 2000 to February 2003,coexistent benign liver tumors were found in 4 (14.8%).In addition to FNH,in three cases,there was a single benign neoplasm (a cavernous hemangioma,hepatic adenoma or bile duct adenoma),and in one case two benign neoplasms (a cavernous heman- gioma and hepatic adenoma).All women were relatively young (23 –55 years,median 35.8)and healthy.All of them had used oral contraceptives for several years.Their only complaints were unspecified epigastric pains.Laboratory parameters and so-called ‘cancer markers ’(AFP,Ca19-9,CEA)were normal.By serological methods,HBV and HCV infections were excluded.Two FNH lesions were 2 cm,and two others about 5 cm in diameter.Morphological appearance of all FNHs was consistent with their classic type.Two coexisting hepatic adenomas were large tumors, measuring 6 x5 x3 cm and 15 x10 x9 cm,respectively.The bile duct adenoma and two hemangiomas were respectively 1.5 cm,2 cm and about 9 cm in diameter.All the lesions were well separated from FNH.In the patient who had FNH and two associated neoplasms,there was an anatomical anomaly of liver circulation,in the form of an accessory right hepatic vein.Conclusions: 1)Coexistence of FNH with benign liver neoplasms was found in 14.8%of surgically treated focal nodular hyperplasia cases.2)Hemangiomas and hepatic adenomas were equally frequent in our material.3)It is possible that in case of neoplasms other than of vascular origin,the most important role in the pathogenesis of FNH is played not by the histological type,but by the size of the tumor.4)It is important to remember that FNH may occur together with more than one benign liver neoplasm. 5)Coexistence of FNH with other focal lesions of the liver,especially solid ones,may represent the clinical problem requiring surgical treatment.
Keywords: focal nodular hyperplasic (FNH), liver adenomas, liver cavernous hemangiomas
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