Amisaki Masataka, Honjo Soichiro, Iida Noriyuki, Kuwamoto Satoshi, Fujiwara Yoshiyuki
Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan.
Division of Molecular Pathology, Department of Pathology, Tottori University Hospital, Yonago, Japan.
Surg Case Rep. 2017 Dec;3(1):59. doi: 10.1186/s40792-017-0332-0. Epub 2017 Apr 28.
Imaging modalities (computed tomography (CT), ultrasonography, and magnetic resonance imaging (MRI)) have only limited ability to distinguish liver focal nodular hyperplasia (FNH) from metastatic liver tumors. Here, we report a patient who underwent surgery for benign FNH that mimicked a liver metastasis from soft tissue sarcoma (STS).
A 23-year-old man with a history of several surgeries for metastatic abdominal STS, developed a hepatic tumor accompanying peritoneal STS recurrence. He was diagnosed with a metastatic liver tumor from the STS, based on imaging studies for the hepatic tumor that showed a growing hypervascular lesion and hypo-intensity in hepatic phase on dynamic CT and MRI. However, when the liver and peritoneal tumors were resected, histological diagnosis showed the hepatic tumor to be benign liver FNH.
Although FNH should be considered as a differential diagnosis for hypervascular hepatic tumors, it has few typical findings, and its appropriate management is controversial. A lesion strongly suspected of being a metastatic liver tumor might require surgical resection.
成像模态（计算机断层扫描（CT）、超声检查和磁共振成像（MRI））在区分肝局灶性结节性增生（FNH）与肝转移瘤方面能力有限。在此，我们报告一名接受手术治疗的患者，其良性FNH被误诊为软组织肉瘤（STS）肝转移。
一名23岁男性，有多次腹部转移性STS手术史，出现伴有腹膜STS复发的肝肿瘤。基于对肝肿瘤的影像学研究，该研究显示动态CT和MRI上肝期有一个不断增大的高血管病变和低强度，他被诊断为STS肝转移瘤。然而，当肝和腹膜肿瘤切除后，组织学诊断显示肝肿瘤为良性肝FNH。
尽管FNH应被视为高血管性肝肿瘤的鉴别诊断，但它几乎没有典型表现，其恰当的处理存在争议。高度怀疑为肝转移瘤的病变可能需要手术切除。
