Decision for Surgery of Focal Nodular Hyperplasia: Single-Center Experience of 17 Adult Cases

Surgery is rarely a necessity for the removal of focal nodular hyperplasia (FNH) lesions. Diagnostic challenges and symptomatic lesions are common indications for surgery. This study was conducted for the purposes of analyzing the indications and results of liver surgeries, revealing FNH in further examinations from specimens sent to pathology. The patients that were operated for liver lesions revealed as FNH at pathological examinations at Ankara University Hospitals between October 2009 and March 2018 were included in this study. Twelve of the patients had some abdominal symptoms, with the remaining four having no reported symptoms. All patients were subjected to at least one imaging modality from computed tomography, ultrasonography or magnetic resonance imaging. Only three patients were diagnosed with certain FNH and were also symptomatic. No jaundice was observed in the group before surgery. Only one patient demonstrated mildly elevated preoperative liver enzyme levels. All patients underwent several types of hepatectomies except for two patients undergoing additional procedures such as pancreatoduodenectomy and cholecystectomy. Only three of the patients had postoperative complications including intraabdominal abscess, biliary leak and pulmonary embolism. No mortality occurred among the group. Surgery is rarely a necessity in the cases of FNH. However, surgical approach is generally preferred when the lesion is suspected to be a lesion other than FNH.