Focal nodular hyperplasia

Case contributed by Dr Doaa Faris Jabaz

Presentation

Recurrent abdominal pain and microscopic hematuria.

Patient Data

Age: 35 years
Gender: Female

Liver: a well-defined oval mass lesion noted at the posterior subcapsular aspect of segment V/VI measure (34x25x25mm, TRAXAPxCC) on the non-contrast series, the lesion is iso-attenuating but shows homogeneous arterial enhancement except for the central scar which remains hypoattenuating, with no enlarged central artery seen. In the portal venous phase, the lesion becomes iso-attenuating to the liver, with no associated fat, calcification, or hemorrhage. Features are consistent with focal nodular hyperplasia.

Case Discussion

Focal nodular hyperplasia (FNH) is a regenerative mass that represents the second most common benign liver lesion after hemangioma with strong female predilection, it may be isoechoic to liver parenchyma and thus not detected on ultrasound, like this case where it first diagnosed on CT scan, most cases are incidentally detected and managed conservatively.  

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