Focal nodular hyperplasia in men: a systematic review

Focal nodular hyperplasia (FNH) is a benign liver tumor commonly found in women, often linked to oral contraceptive use. Its occurrence in men is rare and frequently mimics malignant liver lesions, complicating diagnosis and management. This systematic review aims to evaluate the clinical presentation, diagnostic challenges, and treatment approaches of FNH in male patients.

A systematic review was conducted according to PRISMA guidelines and registered in the PROSPERO database (CRD420245397). PubMed, Web of Science, and ScienceDirect were searched up to July 30, 2024, for studies on FNH in male adults. Data extraction and quality assessment were performed independently by multiple reviewers using the Newcastle-Ottawa Scale.

Out of 1771 records, 20 studies including 38 male patients were analyzed. FNH was incidentally discovered in 22 cases, with most patients asymptomatic or having nonspecific symptoms. Imaging often revealed central stellate scars. Surgical resection was performed in 25 patients, primarily due to diagnostic uncertainty. Observation was chosen in 11 cases.

FNH in men is uncommon and presents diagnostic difficulties due to its overlap with malignancies. The high rate of surgical treatment, even in asymptomatic patients, highlights the need for more accurate, non-invasive diagnostic tools.