Cargando…

Focal nodular hyperplasia on an accessory liver lobe: A case report and literature review

INTRODUCTION: Accessory liver lobe (ALL), an autonomous island of normal liver parenchyma, is a rare congenital anomaly that is difficult for preoperative diagnosis and often identified incidentally. It can also be accompanied with benign or malignant diseases, which is extremely rare. There are onl...

Descripción completa

Detalles Bibliográficos
Autores principales: Su, Na, Chen, Cheng, Dai, Qing, Wang, Liang, Yang, Meng, Xia, Yu, Jiang, Yuxin, Lv, Ke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386996/
https://www.ncbi.nlm.nih.gov/pubmed/32791740
http://dx.doi.org/10.1097/MD.0000000000021357
_version_ 1783564052659699712
author Su, Na
Chen, Cheng
Dai, Qing
Wang, Liang
Yang, Meng
Xia, Yu
Jiang, Yuxin
Lv, Ke
author_facet Su, Na
Chen, Cheng
Dai, Qing
Wang, Liang
Yang, Meng
Xia, Yu
Jiang, Yuxin
Lv, Ke
author_sort Su, Na
collection PubMed
description INTRODUCTION: Accessory liver lobe (ALL), an autonomous island of normal liver parenchyma, is a rare congenital anomaly that is difficult for preoperative diagnosis and often identified incidentally. It can also be accompanied with benign or malignant diseases, which is extremely rare. There are only 3 cases of focal nodular hyperplasia (FNH) detected on ALL reported by previous literature. PATIENT CONCERNS: A 33-year-old woman was incidentally diagnosed with a mass in left upper quadrant abdomen by a routine ultrasound examination. Doppler ultrasound revealed that the mass was attached to left liver lobe with a vascular pedicle. A spoke-wheel artery with diffuse enhancement during hepatic arterial phase was visualized on contrast-enhanced ultrasound, and the mass was continuously hyper-enhanced with a hypo-enhanced intralesional scar during the portal and delayed phase. And contrast-enhanced computed tomography showed a similar enhancement mode of the mass. DIAGNOSIS: The mass was resected and postoperative histopathologic result of the lesion revealed a nodular hyperplastic parenchyma with a central fibrous scar, without tumor cells. And a final diagnosis of FNH on ALL was determined accordingly. INTERVENTIONS: Mass resection was conducted according to patient's demand. OUTCOME: After general postoperative administration, the patient was discharged. Then, she had been undergoing regular serological tests and imaging examinations in our hospital for 24 months. CONCLUSION: The finding of a mass connecting with liver by a stalk should alert the clinician of the possibility of ALL, as well as benign or malignancies on an ALL. This is the first case of FNH on ALL preoperatively confirmed by contrast-enhanced ultrasound. We suggest that an integrated radiologic approach is crucial to evaluate an incidentally detected, asymptomatic abdominal focal mass.
format Online
Article
Text
id pubmed-7386996
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-73869962020-08-05 Focal nodular hyperplasia on an accessory liver lobe: A case report and literature review Su, Na Chen, Cheng Dai, Qing Wang, Liang Yang, Meng Xia, Yu Jiang, Yuxin Lv, Ke Medicine (Baltimore) 6800 INTRODUCTION: Accessory liver lobe (ALL), an autonomous island of normal liver parenchyma, is a rare congenital anomaly that is difficult for preoperative diagnosis and often identified incidentally. It can also be accompanied with benign or malignant diseases, which is extremely rare. There are only 3 cases of focal nodular hyperplasia (FNH) detected on ALL reported by previous literature. PATIENT CONCERNS: A 33-year-old woman was incidentally diagnosed with a mass in left upper quadrant abdomen by a routine ultrasound examination. Doppler ultrasound revealed that the mass was attached to left liver lobe with a vascular pedicle. A spoke-wheel artery with diffuse enhancement during hepatic arterial phase was visualized on contrast-enhanced ultrasound, and the mass was continuously hyper-enhanced with a hypo-enhanced intralesional scar during the portal and delayed phase. And contrast-enhanced computed tomography showed a similar enhancement mode of the mass. DIAGNOSIS: The mass was resected and postoperative histopathologic result of the lesion revealed a nodular hyperplastic parenchyma with a central fibrous scar, without tumor cells. And a final diagnosis of FNH on ALL was determined accordingly. INTERVENTIONS: Mass resection was conducted according to patient's demand. OUTCOME: After general postoperative administration, the patient was discharged. Then, she had been undergoing regular serological tests and imaging examinations in our hospital for 24 months. CONCLUSION: The finding of a mass connecting with liver by a stalk should alert the clinician of the possibility of ALL, as well as benign or malignancies on an ALL. This is the first case of FNH on ALL preoperatively confirmed by contrast-enhanced ultrasound. We suggest that an integrated radiologic approach is crucial to evaluate an incidentally detected, asymptomatic abdominal focal mass. Wolters Kluwer Health 2020-07-24 /pmc/articles/PMC7386996/ /pubmed/32791740 http://dx.doi.org/10.1097/MD.0000000000021357 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 6800
Su, Na
Chen, Cheng
Dai, Qing
Wang, Liang
Yang, Meng
Xia, Yu
Jiang, Yuxin
Lv, Ke
Focal nodular hyperplasia on an accessory liver lobe: A case report and literature review
title Focal nodular hyperplasia on an accessory liver lobe: A case report and literature review
title_full Focal nodular hyperplasia on an accessory liver lobe: A case report and literature review
title_fullStr Focal nodular hyperplasia on an accessory liver lobe: A case report and literature review
title_full_unstemmed Focal nodular hyperplasia on an accessory liver lobe: A case report and literature review
title_short Focal nodular hyperplasia on an accessory liver lobe: A case report and literature review
title_sort focal nodular hyperplasia on an accessory liver lobe: a case report and literature review
topic 6800
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386996/
https://www.ncbi.nlm.nih.gov/pubmed/32791740
http://dx.doi.org/10.1097/MD.0000000000021357
work_keys_str_mv AT suna focalnodularhyperplasiaonanaccessoryliverlobeacasereportandliteraturereview
AT chencheng focalnodularhyperplasiaonanaccessoryliverlobeacasereportandliteraturereview
AT daiqing focalnodularhyperplasiaonanaccessoryliverlobeacasereportandliteraturereview
AT wangliang focalnodularhyperplasiaonanaccessoryliverlobeacasereportandliteraturereview
AT yangmeng focalnodularhyperplasiaonanaccessoryliverlobeacasereportandliteraturereview
AT xiayu focalnodularhyperplasiaonanaccessoryliverlobeacasereportandliteraturereview
AT jiangyuxin focalnodularhyperplasiaonanaccessoryliverlobeacasereportandliteraturereview
AT lvke focalnodularhyperplasiaonanaccessoryliverlobeacasereportandliteraturereview