Alpha‐fetoprotein and focal nodular hyperplasia: An unconventional couple

We report the case of a 36‐year‐old patient who was initially managed for gynecomastia. The first biological analyses showed a moderately elevated alpha‐fetoprotein (AFP) level. After an endocrine etiology was excluded, an abdominal computed tomography scan showed typical focal nodular hyperplasia (FNH) proven by biopsy and showing expression of AFP in FNH cells. After follow‐up for 24 months, the serum AFP and liver radiology remained unchanged. The association between an elevated AFP and FNH is rarely described in the medical literature. We report the case of a 36‐year‐old patient who was initially managed for a gynecomastia. First biological analyses showed a moderately elevated alpha‐fetoprotein (AFP) level. An endocrine etiology was then ruled out; the computed tomography scan showed a typical focal nodular hyperplasia (FNH), which was biopsy‐proven with AFP expressed on FNH cells. After a follow‐up of 24 months, the serum AFP concentration and the liver iconography remained unchanged. This link between elevated serum AFP and FNH rarely described in the literature, should be emphasized.