Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2021; 9(32): 9977-9981
Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9977
Large focal nodular hyperplasia is unresponsive to arterial embolization: A case report
Hui Ren, Yin-Jie Gao, Xue-Mei Ma, Shao-Tang Zhou
Hui Ren, Yin-Jie Gao, Xue-Mei Ma, Shao-Tang Zhou, Department of Hepatobiliary and Liver Transplant Center, The Fifth Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100039, China
Author contributions: Ren H and Gao YJ equally contributed to the work; Ren H wrote the draft; Gao YJ revised the draft; Ma XM collected and analyzed the data; Zhou ST conceived and finalized the draft.
Informed consent statement: The patient and his family agreed that the information on his illness was published.
Conflict-of-interest statement: None of conflict of interest was disclosed.
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).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shao-Tang Zhou, MD, PhD, Doctor, Senior Scientist, Department of Hepatobiliary and Liver Transplant Center, The Fifth Medical Center, Chinese People’s Liberation Army General Hospital, No. 100 Xisihuan Middle Road, Fengtai District, Beijing 100039, China. zhoust71@163.com
Received: June 19, 2021
Peer-review started: June 19, 2021
First decision: July 5, 2021
Revised: July 11, 2021
Accepted: September 8, 2021
Article in press: September 8, 2021
Published online: November 16, 2021
Abstract
BACKGROUND

Focal nodular hyperplasia (FNH) commonly occurs in women; it is usually asymptomatic and sometimes difficult to differentiate from hepatocellular carcinoma (HCC).

CASE SUMMARY

A large space-occupying lesion in the right lobe of the liver was incidentally detected in an adult man and diagnosed as HCC. Transcatheter arterial chemoembolization was applied once monthly for 2 years, but the lesion did not decrease in size. It was revealed by biopsy to be FNH. Eleven years later, the patient underwent liver resection due to hemorrhage and the pathological examination confirmed FNH.

CONCLUSION

For a space-occupying lesion, it is prerequisite to pathologically confirm the diagnosis and the corresponding intervention can be effective.

Keywords: Focal nodular hyperplasia, Large focal nodular hyperplasia, Transarterial embolization, Hepatocellular carcinoma, Case report

Core Tip: We report a case of large focal nodular hyperplasia that was pre-emptively diagnosed by a physician as hepatocellular carcinoma. Consequently, the management was incorrect and ineffective, which raises an alert for all clinicians.