Pedunculated focal nodular hyperplasia complicated by torsion: a very rare atypical presentation

Yeison R. Gómez-Ledesma, Facultad de Medicina, Universidad CES, Medellín, Colombia
Catalina Cuervo-Valencia, Departamento de Radiología, Hospital Pablo Tobón Uribe, Medellín, Colombia
Catalina Posada-Cuartas, Departamento de Radiología, Prodiagnóstico, Medellín, Colombia
Sergio Hoyos, Unidad de Cirugía Hepatobiliar y Trasplante Hepático, Hospital Pablo Tobón Uribe; Grupo de Gastrohepatología, Universidad de Antioquia. Medellín, Colombia
Andrés F. Latorre-Pinto, Facultad de Medicina, Universidad CES, Medellín, Colombia

Focal nodular hyperplasia (FNH) is a benign hepatic tumor that arises as a response to a probable vascular anomaly. It consists of a reactive hyperplastic growth of normal hepatocytes, a central scar with radial layout containing portal tracts and abnormal blood vessels, surrounded by normal hepatic parenchyma. It accounts for up to 8% of all primary hepatic tumors, being the second most common among benign neoplasms. It is more frequent in women, with intrahepatic localization in the right lobe and usually asymptomatic. Pedunculated FNH is the rarest atypical form of FNH, located in the extrahepatic region and connected to the liver by a pedicle. It is more commonly associated with symptoms and complications, thus surgical management is indicated. We report the case of a 19-year-old female patient presenting with a pedunculated FNH with torsion of the pedicle, requiring surgical management, with satisfactory postoperative evolution.

Keywords: Focal nodular hyperplasia. Pedunculated liver tumor. Liver neoplasms.