Focal nodular hyperplasia of the liver: results of treatment and options in management

Article Abstract:

Focal nodular hyperplasia of the liver is a rare condition characterized by excessive cell growth (hyperplasia), that occurs most often in women of child-bearing age. The condition is often asymptomatic and discovered incidentally during surgery for another condition; sometimes pain or a palpable mass indicate the presence of scar tissue in the liver. Little is known about the natural history of the condition or the optimal treatment strategy for this condition. To further categorize this disorder, the records of 22 patients (19 women) with focal nodular hyperplasia of the liver were reviewed. Fourteen of the patients had symptoms, such as pain or swelling, which led to diagnosis; the remaining patients were symptom-free. Of the 14 adult women in the group, 12 had taken oral contraceptives. Twelve patients underwent surgical removal of the hyperplastic region; four patients underwent hepatic artery ligation. Five patients were given no treatment (conservative treatment); two of these asymptomatic patients remained symptom-free, whereas one patient who was taking oral contraceptives became symptom-free when she stopped taking these pills. Hence, this relatively benign condition requires a flexible approach to treatment. In some cases, conservative treatment will suffice; the majority of cases, requiring more active management, respond favorably to surgical removal of the hyperplastic focus. In a minority of cases, the symptoms may be induced by oral contraceptive use but these symptoms improve after discontinuation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Physiological aspects, Liver diseases, Liver, Oral contraceptives

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Focal nodular hyperplasia of the liver: a link with sickle cell disease?

Article Abstract:

Sickle cell disease is a hereditary disorder characterized by the formation of abnormal red blood cells that have a sickle or crescent shape, and the production of abnormal hemoglobin, the oxygen-carrying pigment of red blood cells. A case is described of a six-year-old girl with sickle cell disease complicated by focal nodular hyperplasia of the liver. This tumor is characterized by a well-defined area of hyperplasia, the excessive overgrowth of cells, in liver tissue, and may be accompanied the formation of star-shaped fiber-like scar tissue. The lesion is usually not associated with symptoms and may be discovered accidentally. Focal nodular hyperplasia of the liver is rare and occurs most often in women of child-bearing age. Oral contraceptives may contribute to the development of this liver tumor. Fewer than 20 percent of cases of focal nodular hyperplasia of the liver occur in children and this is the second reported case of sickle cell disease associated with focal nodular hyperplasia of the liver. This liver tumor can be diagnosed by biopsy of the liver and by ultrasound imaging. The tumor can be surgically removed, and symptoms in those taking oral contraceptives may resolve following their discontinuation. Possible mechanisms underlying the development of focal nodular hyperplasia of the liver are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Sickle cell anemia, Liver tumors

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Intraluminal biliary obstruction

Article Abstract:

Jaundice can be caused by an obstruction in the duct or tube that carries bile from the gallbladder to the small intestine. The bile duct can become obstructed when the bile becomes very thick (inspissated bile plug syndrome, IBPS) or when gall stones form in the gallbladder. Recently, there has been an increase in the number of cases of IBPS in infants. IBPS has been reported to be associated with parenteral nutrition, treatment with diuretics, bowel dysfunction, and disseminated intravascular coagulation (a blood clotting disorder). This article describes the case reports of nine male infants with jaundice caused by an obstructed bile duct. The infants were between two weeks and six months of age. Seven of the infants had IBPS and two had gall stones. Ultrasound scans proved useful in diagnosing IBPS and gall stones. Eight of the infants required surgery to clear the bile duct. Drainage of the biliary tract was required in six cases, and the gallbladder was removed in four cases. In one case the obstruction disappeared following percutaneous cholangiography (a procedure used to examine the bile ducts). Ultrasound scans (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Abnormalities, Infants (Newborn), Newborn infants, Cholestasis, Bile ducts, Jaundice, Obstructive

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