title: Complete spontaneous regression of giant focal nodular hyperplasia of the liver: Magnetic resonance imaging evaluation with hepatobiliary contrast media.
abstract: Focal nodular hyperplasia (FNH) of the liver is a benign lesion occurring in 0.6%-3% of the general population that probably reflects a local hyperplastic response of hepatocytes to a vascular abnormality. Most lesions are diagnosed incidentally and the natural history of the disease remains largely unknown. It has been shown that most FNH remain stable, or even regress, over a long follow-up period. We present a patient with FNH of the liver who was followed up for 7 years. A 26-year-old woman with a 5-year history of oral contraceptive use was referred to our hospital in February 2005 for further examination of a liver tumour. The diagnosis of FNH was made using magnetic resonance (MR) imaging with hepatospecific contrast media; this technique allows a correct diagnosis, in particular distinguishing FNH from hepatic adenoma, avoiding an invasive procedure such as the lesion biopsy. After 7-year from the diagnosis, we observed the complete spontaneous regression of the lesion by enhanced MR scanning. In this patient, discontinuation of oral contraceptive use and two childbirths may have influenced the natural history of FNH. To our knowledge, in the English literature there is no report illustrating a complete regression of giant FNH but only studies of decreasing in size. The present case suggests that a young patient with giant FNH should be managed conservatively rather than by resection, because FNH has the potential for spontaneous regression.
authors.affiliation: Giuseppe Mamone, Settimo Caruso, Roberto Miraglia, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), 90127 Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mamone
authors.affiliation: Giuseppe Mamone, Settimo Caruso, Roberto Miraglia, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), 90127 Palermo, Italy.
authors.forename: Settimo
authors.initials: S
authors.lastname: Caruso
authors.affiliation: Giuseppe Mamone, Settimo Caruso, Roberto Miraglia, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), 90127 Palermo, Italy.
authors.forename: Kelvin
authors.initials: K
authors.lastname: Cortis
authors.affiliation: Giuseppe Mamone, Settimo Caruso, Roberto Miraglia, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), 90127 Palermo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Miraglia
mesh_terms: D000328:Adult; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D036801:Parturition; D011237:Predictive Value of Tests; D011247:Pregnancy; D012075:Remission, Spontaneous; D013997:Time Factors
chemical_list: D003278:Contraceptives, Oral, Hormonal; D003287:Contrast Media
keywords: Focal nodular hyperplasia; Magnetic resonance; Oral contraceptives; Pregnancy; Regression