Hepatic hamartoma plus solitary necrotic nodule: case report and review of the literature

Abstract

Focal nodular hyperplasia is the second most frequent benign tumor of the liver, predominantly in females, between 35-50 years of age. The present case deals with a 34 year old female patient, who reports abdominal pain of 06 months of evolution, located in the epigastrium, insidious onset, moderate intensity, burning; Associated with early satiety and postprandial fullness. On physical examination, the abdomen was painful on deep palpation of the epigastrium. Sonographically, a well defined, oval, heterogeneous lesion measuring 6 x 6 x 6 cm and a volume of 123 ml was observed in the left hepatic lobe, segments II and III. Triphasic contrast abdominal tomography revealed a homogeneous, well defined lesion isodense to the liver parenchyma in the basal phase, in whose arterial phase there is intense and homogeneous uptake with a hypodense central scar. Taking into account the characteristics of the lesion and the presence of gastrointestinal symptoms, she is taken to the operating table where an exploratory laparotomy + left hepatectomy is performed, finding a 7 cm diameter lesion in segments II and III, being reported by pathology as Nonclassic focal nodular hyperplasia of the liver with telangiectatic changes. The patient is currently under follow-up without any eventuality.