FOCAL NODULAR HYPERPLASIA OF THE LIVER - A RETROSPECTIVE REVIEW OF 20PATIENTS MANAGED SURGICALLY

Focal nodular hyperplasia remains a difficult diagnostic and clinical dilemma. Over a 10-year period, 20 patients with this diagnosis underw ent surgery in our service. Eight of the patients had focal nodular hy perplasia discovered incidentally as part of investigation or surgery for other unrelated conditions. Seventeen of the patients were female, with 64% receiving oral contraceptives. In the 12 patients without co ncomitant disease all but one had upper abdominal pain. Despite the us e of CT scan, isotope studies, NMR, angiography, ultrasound and biopsy , a firm preoperative diagnosis of focal nodular hyperplasia was made in only one patient. Resective surgery was performed without complicat ion in all cases. During a mean follow-up of 42 months (range 6-128 mo nths) one patient died from lymphoma and two patients had recurrent ab dominal pain. This study highlights the difficulty in preoperative dia gnosis of focal nodular hyperplasia. Conservative treatment can be con sidered or resective surgery safely performed for symptomatic or suspe ct lesions.