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BMJ Case Rep. 2013 Jun 26;2013. pii: bcr2013010250. doi: 10.1136/bcr-2013-010250.

Von Meyenburg complexes mimicking metastatic disease at laparotomy for focal nodular hyperplasia.

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  • 1Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.


A 44-year-old woman presented with symptoms of fatigue and increasing abdominal discomfort. MRI with the hepatobiliary contrast Gd-EOB-DTPA (Primovist) was performed showing a 6 cm lesion in segment 2/3 of the liver typical for focal nodular hyperplasia (FNH). Because of severe complaints attributed to the lesion, the patient was scheduled for resection. At laparotomy multiple small white lesions were found throughout the liver with enlarged locoregional lymph nodes. Macroscopically, the findings could be consistent with widespread metastases and the surgeon felt compelled to determine the nature of these lesions before continuing resection. Final diagnosis revealed multiple bile duct hamartomas and an FNH lesion as was expected.

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