Focal nodular hyperplasia associated with a giant hepatocellular adenoma: A case report and review of literature

doi:10.4254/wjh.v13.i10.1450

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Oct 27, 2021 (publication date) through Feb 12, 2026

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World Journal of Hepatology

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World J Hepatol. Oct 27, 2021; 13(10): 1450-1458
Published online Oct 27, 2021. doi: 10.4254/wjh.v13.i10.1450

Focal nodular hyperplasia associated with a giant hepatocellular adenoma: A case report and review of literature

Sérgio Gaspar-Figueiredo, Amaniel Kefleyesus, Christine Sempoux, Emilie Uldry, Nermin Halkic

Sérgio Gaspar-Figueiredo, Amaniel Kefleyesus, Emilie Uldry, Nermin Halkic, Department of Visceral Surgery, Lausanne University Hospital, Lausanne 1011, Switzerland

Christine Sempoux, Department of Pathology, Lausanne University Hospital, Lausanne 1011, Switzerland

Author contributions: Gaspar-Figueiredo S and Kefleyesus A performed the literature review, collected all the data related to the case report, and recorded/edited the video-vignette related to the case report; Sempoux C did the anatomopathological examination/appraisal; Halkic N and Uldry E did the surgical appraisal; all authors have read and approved the final manuscript.

Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.

Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Nermin Halkic, MD, PhD, Chief Doctor, Professor, Department of Visceral Surgery, Lausanne University Hospital, Rue du Bugnon 46, Lausanne 1011, Switzerland. nermin.halkic@chuv.ch

Received: April 25, 2021
Peer-review started: April 25, 2021
First decision: June 4, 2021
Revised: June 15, 2021
Accepted: August 31, 2021
Article in press: August 31, 2021
Published online: October 27, 2021
Processing time: 179 Days and 15.5 Hours

Abstract

BACKGROUND

Focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) are well-known benign liver lesions. Surgical treatment is usually chosen for symptomatic patients, lesions more than 5 cm, and uncertainty of diagnosis.

CASE SUMMARY

We described the case of a large liver composite tumor in an asymptomatic 34-year-old female under oral contraceptive for 17-years. The imaging work-out described two components in this liver tumor; measuring 6 cm × 6 cm and 14 cm × 12 cm × 6 cm. The multidisciplinary team suggested surgery for this young woman with an unclear HCA diagnosis. She underwent a laparoscopic left liver lobectomy, with an uneventful postoperative course. Final pathological examination confirmed FNH associated with a large HCA. This manuscript aimed to make a literature review of the current management in this particular situation of large simultaneous benign liver tumors.

CONCLUSION

The simultaneous presence of benign composite liver tumors is rare. This case highlights the management in a multidisciplinary team setting.

Keywords: Liver; Focal nodular hyperplasia; Hepatocellular adenoma; Composite tumor; Video vignette; Case report

Core Tip: Focal nodular hyperplasia and hepatocellular adenoma (HCA) are frequent but non-malignant tumors. There is rarely indication for surgery. Combination of these two masses is a very unusual situation. Their diagnosis is mainly based on radiology. Oral contraception is a risk factor for HCA. Malignant transformation of HCA is the predominant argument for surgery. All these cases, especially composite tumors, must be discussed in a multidisciplinary team.