Department of Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan.
Asian J Endosc Surg. 2023 Jul;16(3):579-583. doi: 10.1111/ases.13188. Epub 2023 Apr 10.
Focal nodular hyperplasia (FNH) is a rare benign hepatic tumor which is frequently observed in women of reproductive age, and therapeutic intervention needs to be considered in cases wherein the tumor has a risk of rupture. The laparoscopic approach is beneficial, especially for young women, but is often challenging because the tumor is large and hemorrhagic. Herein, we report a case of large FNH in a 22-year-old woman. The patient was asymptomatic; however, the tumor was approximately 15 cm in diameter and protruded from the liver. Given the risk of rupture, we decided to perform surgical resection. Preoperative transcatheter arterial embolization led to rapid shrinkage of the tumor and control of intraoperative bleeding, which enabled us to safely perform laparoscopic liver resection. The combination of surgical resection with intravascular embolization may be a promising therapeutic option for hypervascular tumors such as FNH.
局灶性结节性增生(FNH)是一种罕见的良性肝肿瘤,多见于育龄期妇女,当肿瘤有破裂风险时需要考虑治疗干预。腹腔镜方法是有益的,特别是对年轻女性,但往往具有挑战性,因为肿瘤较大且易出血。在此,我们报告了一例 22 岁女性的巨大 FNH 病例。患者无症状;然而,肿瘤直径约 15 厘米,并从肝脏突出。鉴于破裂的风险,我们决定进行手术切除。术前经导管动脉栓塞导致肿瘤迅速缩小并控制术中出血,使我们能够安全地进行腹腔镜肝切除术。手术切除结合血管内栓塞可能是 FNH 等富血管肿瘤的一种有前途的治疗选择。