Villavicencio Kim Jaimy, Wu George Y
Division of Gastroenterology-Hepatology, University of Connecticut Health Center, Farmington, CT, USA.
J Clin Transl Hepatol. 2024 Feb 28;12(2):182-190. doi: 10.14218/JCTH.2023.00265. Epub 2024 Jan 2.
Focal nodular hyperplasia is a benign tumor of the liver that is often found incidentally with imaging. The purpose of this review is to discuss the pathophysiology, rare complications that can occur due to these lesions, and management options. A literature review was performed on clinical trials and case reports involving focal nodular hyperplasia complications and management of these, as well as the proposed pathogenesis underlying these tumors. Although exposure to oral contraceptive pills and endogenous hormones have been thought to play a role in the development of these lesions, this has not been proven. Most recently, they are thought to arise as a consequence of a vascular anomaly causing alterations in the expression of angiopoietin genes. Complications are rare, but previous cases have reported associated pain, rupture and compression of nearby structures (hepatic vein, stomach, biliary system). Resection of focal nodular hyperplasia is not usually recommended. However, if there is associated pain with no other identifiable cause or presence of a large or growing lesion with risk of causing a complication, then surgical resection, radiofrequency ablation or arterial embolization should be considered.
局灶性结节性增生是一种肝脏良性肿瘤，常在影像学检查时偶然发现。本综述的目的是讨论其病理生理学、这些病变可能引发的罕见并发症以及治疗选择。我们对涉及局灶性结节性增生并发症及其治疗以及这些肿瘤潜在发病机制的临床试验和病例报告进行了文献综述。尽管口服避孕药和内源性激素被认为在这些病变的发生中起作用，但这尚未得到证实。最近，人们认为它们是由血管异常导致血管生成素基因表达改变而产生的。并发症很少见，但既往病例报告有相关疼痛、破裂以及对附近结构（肝静脉、胃、胆道系统）的压迫。通常不建议切除局灶性结节性增生。然而，如果存在无其他可识别原因的相关疼痛，或者存在有引起并发症风险的大的或正在生长的病变，则应考虑手术切除、射频消融或动脉栓塞。
