{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T12:46:42Z","timestamp":1782996402191,"version":"3.54.5"},"reference-count":29,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,6,16]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>This case presents a progression from benign focal nodular hyperplasia (FNH) to hepatocellular carcinoma (HCC) in a middle-aged patient undergoing private testosterone therapy for andropause. The patient presented to their general practitioner with fatigue and pruritus; routine blood tests showed deranged liver function tests. Historical records indicated a large FNH lesion that was stable for decades and required no intervention.<\/jats:p>\n                  <jats:p>Subsequent imaging demonstrated a mass within the right lobe suggestive of malignant transformation. Multidisciplinary discussion concluded the lesion likely represented HCC or hepatic adenoma. The patient underwent a successful robotic right hemihepatectomy. Histopathology confirmed well-differentiated HCC with macroscopic vascular invasion (pT2N0M0). Postoperative imaging showed no evidence of recurrence or metastasis, and liver function returned to normal.<\/jats:p>\n                  <jats:p>This case underscores the potential for malignant transformation in large FNH-like lesions despite prolonged radiological stability. It emphasises the role of imaging surveillance and robotic surgery as effective curative strategies.<\/jats:p>","DOI":"10.1136\/bcr-2025-270444","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T12:05:59Z","timestamp":1782993959000},"page":"e270444","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Can focal nodular hyperplasia transform into hepatocellular carcinoma? 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