FOCAL NODULAR HYPERPLASIA OF THE LIVER

The management of focal nodular hyperplasia (FNH) of the liver require s a systematic approach. After a histologic diagnosis of FNH is obtain ed, asymptomatic lesions can be observed safely with regular follow-up and treated if they become symptomatic or enlargement occurs. In the case presented here, we have elected follow-up with serial CT scans be cause our patient is asymptomatic and the lesion has not significantly enlarged. Patients who have symptomatic lesions while taking an oral contraceptive can have conservative follow-up when they stop taking th e oral contraceptive, because regression of FNH has been reported to o ccur after cessation of oral contraceptive use. If the patient remains symptomatic or if the lesion enlarges after discontinuance of oral co ntraceptive use, surgical resection is warranted. Other symptomatic pa tients, including those with a previous history of taking oral contrac eptives, should be treated by surgical resection or, when resection is not possible, by embolization or ligation of the hepatic artery, beca use symptomatic patients are at risk for having malignant lesions misd iagnosed as FNH.