What is a major treatment indication for focal nodular hyperplasia?

Focal nodular hyperplasia (FNH) is a benign liver lesion that is usually asymptomatic and discovered incidentally during imaging studies. In the vast majority of cases, it does not require any intervention. However, if the lesion becomes symptomatic—manifesting as pain or complications due to size or location—surgical resection is often indicated. Resection is considered when there is a clear symptomatic presentation that could significantly affect the patient's quality of life, or if there are concerns about potential confusion with malignant lesions.

In cases where FNH remains asymptomatic, careful monitoring and observation are typically the preferred management strategy, as these lesions rarely lead to serious complications or cause significant health issues for the patient. Therefore, the need for resection is specifically highlighted for symptomatic cases, distinguishing it as a major treatment indication for this condition. Other treatment modalities, such as chemotherapy or radiation therapy, are not applicable to FNH due to its benign nature and lack of malignant transformation potential.