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Title: Incidental focal nodular hyperplasia in male adults: 10-year experience of a large liver centre Authors: Corallo C, Smith C, Bell J, Kaye T, Laverty A, Mohsin M, Prasad R, Albazaz RInstitution: Departments of Clinical Radiology and Surgery, St James’s University Hospital, Leeds, LS9 7TF, UKBackgroundFocal nodular hyperplasia (FNH) is commonly found in females of reproductive age. In males, the diagnosis is made more cautiously due to its lower incidence and higher incidence of hepatocellular carcinoma, which can have overlapping imaging features. Follow-up or biopsy is sometimes required. This retrospective study aims to assess management of suspected FNH in male adult patients at our institution over a 10-year period.MethodsMale adults (≥18 years) suspected of having FNH on MRI from January 2010 - June 2020 were identified using a departmental radiology information system search. Data was collected from radiology reports and patient pathway manager.ResultsOf 342 patients with suspected FNH, 62 were male (18.1%; F:M of 4.5:1; mean age 45.5 years, range 18-74 years). Background liver disease present in 24/62 (38.7%), majority with hepatic steatosis. Average number of lesions per patient 1.7 regardless of background liver disease. 27/62 (43.5%) had at least one radiological follow up, almost exclusively MRI using liver specific contrast, with 8 lesions demonstrating variation in size (range growth: -3.27 mm/year to +4 mm/year). In 7 cases, MRI was not definitive; 6 required biopsy and 1 resection. Only 2/7 demonstrated malignancy. Of the total 62 patients, 6 have deceased and none due to a misdiagnosed or mismanaged hepatic lesion.DiscussionFNH is relatively uncommon in males, however our data suggests that lesions with typical MRI characteristics do not require follow-up and diagnosis can be made confidently, similar to females. Any atypical features should prompt a biopsy. ................
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