# Arterial embolization of focal nodular hyperplasia of the liver: A case report

## TL;DR

This case report shows that arterial embolization can effectively treat a large focal nodular hyperplasia (FNH) liver lesion, reducing its size and resolving symptoms.

## Contribution

The paper demonstrates the effectiveness of arterial embolization as a less invasive treatment for large FNH lesions.

## Key findings

- Arterial embolization led to complete symptom resolution and a significant reduction in lesion size from 25 cm to 12 cm.
- The case supports the use of arterial embolization as a viable alternative to traditional surgery for managing large FNH lesions.
- Thorough histopathological and imaging assessments are crucial for accurate diagnosis of FNH.

## Abstract

Focal nodular hyperplasia (FNH) is a benign liver lesion that can pose diagnostic and management dilemmas, especially when distinguishing it from other hypervascular hepatic lesions. The benign nature of FNH often makes conservative management a priority; however, intervention may be necessary in symptomatic cases or when diagnostic uncertainty exists.

A 19-year-old male presenting with abdominal pain, found to have a large 25 cm FNH lesion in the right lobe of the liver. Initial diagnosis was achieved through ultrasonography and contrast-enhanced computed tomography (CECT), with histopathological confirmation via core needle biopsy. Given the lesion's size and the patient's symptomatic presentation, we opted for arterial embolization, a less invasive surgical approach, over traditional resection methods. This technique not only led to symptom resolution but also resulted in a significant reduction in lesion size.

Our approach to managing this FNH case involved a multidisciplinary team. The decision to employ arterial embolization over more invasive surgical options was based on the lesion's characteristics, the patient's age, and the potential for significant morbidity associated with traditional surgery. Arterial embolization of the FNH lesion resulted in complete resolution of symptoms and a significant reduction in lesion size, from 25 cm to 12 cm, demonstrating the effectiveness of this technique in managing large FNH lesions.

Our findings contribute to the scientific literature by showcasing the potential of less invasive surgical techniques in the management of FNH, offering valuable insights for clinicians faced with similar diagnostic and therapeutic challenges.

•The case highlights how arterial embolization can be an effective treatment for FNH, leading to significant symptom resolution and size reduction of the lesion, thus contributing valuable insights into less invasive treatment options for FNH.•The report demonstrates the importance of thorough histopathological examination and imaging techniques in achieving a correct diagnosis, particularly given FNH's often asymptomatic nature and the potential for small biopsy samples to provide limited information.•The case presents arterial embolization as a successful treatment strategy for a patient with FNH, showcasing its effectiveness in not only alleviating symptoms but also in significantly reducing the size of the lesion.

The case highlights how arterial embolization can be an effective treatment for FNH, leading to significant symptom resolution and size reduction of the lesion, thus contributing valuable insights into less invasive treatment options for FNH.

The report demonstrates the importance of thorough histopathological examination and imaging techniques in achieving a correct diagnosis, particularly given FNH's often asymptomatic nature and the potential for small biopsy samples to provide limited information.

The case presents arterial embolization as a successful treatment strategy for a patient with FNH, showcasing its effectiveness in not only alleviating symptoms but also in significantly reducing the size of the lesion.