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Focal Nodular Hyperplasia (FNH)

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What Is Focal Nodular Hyperplasia (FNH)?

FNH is a benign tumor, or lesion, that forms in the liver. These tumors are not cancer.

FNH is more common in women, mostly between the ages of 20 and 50.

It's the 2nd most common type of benign liver tumor (liver hemangiomas are the most common).

FNH affects between 0.6% and 3% of the general U.S. population. About 8% of all benign liver tumors that aren't hemangiomas are FNH.

FNH causes

Doctors don't know for sure what causes FNH.

Researchers think hormones like estrogen might play a role in causing these tumors to form.

FNH risk factors and complications

FNH doesn't become cancerous. Most people with the disease don't have any problems and the tumors often don't change much over time.

Sometimes, the lesions get bigger, especially in women who are pregnant or who take birth control pills.

If you have a liver hemangioma, you might be at increased risk for FNH.

Researchers are also looking into whether gene changes or mutations play a role in FNH.

Why choose the Center for Liver Diseases for focal nodular hyperplasia care?

At the UPMC Center for Liver Diseases, our experts:

  • Treat all types of benign liver tumors like FNH, as well as other liver diseases.
  • Perform endless hours of research and develop new treatments to manage FNH and liver disease.
  • Work closely with experts in the UPMC Liver Cancer Center and the Liver Transplant Program.

Focal Nodular Hyperplasia (FNH) Symptoms and Diagnosis

Most people with FNH don't have any symptoms. These tumors most often between 4 and 8 centimeters in size.

Rarely, some people with FNH feel a lump or pain in the stomach.

Diagnosing FNH

Often, doctors find FNH during imaging scans for other conditions.

Doctors can confirm a diagnosis of FNH with a liver biopsy. They'll take a small sample of liver tissue and send it to the lab to look at under a microscope.

FNH tumors have a special type of scar formed from different tissue types. This “central scar" tells doctors that the tumor is FNH and not hepatocellular carcinoma.

Focal Nodular Hyperplasia (FNH) Treatment

FNH tumors do not become cancer. In most cases, doctors only treat FNH that causes symptoms.

Your liver doctor will want to see you every three to six months for follow-ups and imaging tests.

These appointments and scans are to make sure the tumor isn't growing.

Lifestyle changes to treat FNH

Doctors might suggest you stop taking birth control pills if you have FNH. If you keep taking them, your doctor might want you to have routine imaging tests to keep an eye on the tumor.

To support your liver's health, doctors might also urge that you:

  • Eat a healthy diet.
  • Maintain a healthy weight.
  • Exercise.
  • Avoid alcohol.

Trans-arterial embolization (TACE) to treat FNH

If your tumor gets larger than the typical 4 to 8 centimeters , doctors may use TACE to shrink it.

During TACE, specialists will inject medicine into the hepatic artery to block blood flow and prevent the mass from growing.

Surgery to treat focal nodular hyperplasia

If the FNH is large, surgeons may remove the tumor.

In partial hepatectomy surgery, or resection, surgeons extract the tumor and a small part of the tissue around it.