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Growth of Focal Nodular Hyperplasia is Not a Reason for Surgical Intervention, but Patients Should be Referred to a Tertiary Referral Centre.
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.
Afiliação
  • Bröker MEE; Department of Surgery, Erasmus Medical Centre, 's Gravendijkwal 230, 3000 CA, Rotterdam, The Netherlands.
  • Klompenhouwer AJ; Department of Surgery, Erasmus Medical Centre, 's Gravendijkwal 230, 3000 CA, Rotterdam, The Netherlands.
  • Gaspersz MP; Department of Surgery, Erasmus Medical Centre, 's Gravendijkwal 230, 3000 CA, Rotterdam, The Netherlands.
  • Alleleyn AME; Department of Surgery, Erasmus Medical Centre, 's Gravendijkwal 230, 3000 CA, Rotterdam, The Netherlands.
  • Dwarkasing RS; Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
  • Pieters IC; Department of Radiology, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands.
  • de Man RA; Department of Gastroenterology and Hepatology, Erasmus Medical Centre, Rotterdam, The Netherlands.
  • IJzermans JNM; Department of Surgery, Erasmus Medical Centre, 's Gravendijkwal 230, 3000 CA, Rotterdam, The Netherlands. j.ijzermans@erasmusmc.nl.
World J Surg ; 42(5): 1506-1513, 2018 05.
Article em En | MEDLINE | ID: mdl-29167952
ABSTRACT

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.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2018 Tipo de documento: Article