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How to manage focal nodular hyperplasia of the liver during pregnancy?

Q: I have a nodular focal hyperplasia of 9 cm in my liver. I am a symptomatic 32 years old woman that would have a child this year. What is your opinion about the management of this lesion?

A:I presume you mean that you are asymptomatic although you have not made it very clear. You have also not made clear whether you are pregnant at the moment. You say you will have a child this year. Do you mean that you are planning to have a child or does it mean you are already pregnant and will deliver a child this year? I assume you are delivering a child this year. Focal nodular hyperplasia is a benign condition sometimes associated with oral contraceptive medication. It is a benign condition and usually does not cause any problems. However in some women during pregnancy this focal nodular hyperplasia can enlarge and rarely can bleed. It is advisable that you should have an ultrasound examination of her liver at frequent intervals during the pregnancy to find if the size of the mass has increased. You should also have an alpha-fetoprotein to exclude any other cause for this mass such as hepatoma. I feel that you should be under close observation with frequent ultrasound examination, maybe at 2 monthly intervals.

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