New-Onset Focal Nodular Hyperplasia in a Patient with Viral Hepatitis: A Case Report

Abstract

Background: New-onset hepatic nodules mostly are hepatocellular carcinomas in patients with viral hepatitis. Focal Nodular Hyperplasia (FNH) is the second most common benign liver tumor, which usually does not recur after surgical resection. We present a case of hepatitis B virus infected female with a new-onset FNH during pregnancy, which has not been reported before, to not only put an emphasis on the diagnostic accuracy of FNH but also avoid unnecessary surgical intervention. Case presentation: The 28-year-old Chinese female with chronic hepatitis B virus infection who underwent a resection of FNH in the left lobe of the liver three years ago, was found to present with a new-onset solid lesion in the right lobe of the liver. Contrast-Enhanced Ultrasound (CEUS) demonstrated a typical FNH of spoke wheel pattern enhancement in the arterial phase, still enhanced during the portal venous and delayed phases with a central stellate scar, which showed a similar enhancement pattern on contrast-enhanced CT and MRI. Finally, a core needle biopsy of the suspected lesion was confirmed to be FNH. Conclusion: Regenerate of FNH may also occur in patients with chronic hepatitis B, which was known as a risk factor for the occurrence of hepatocellular carcinoma. Diagnosis of FNH can be made definitely and non-invasively through the appliance of modern imaging modalities with typical performance of imaging features.