Hepatobiliary and pancreatic surgery: focal nodular hyperplasia: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hepatobiliary and pancreatic surgery: focal nodular hyperplasia

Sample item

A 29-year-old woman has an incidental 4 cm liver lesion on ultrasound. MRI shows a well-circumscribed lesion with bright arterial enhancement and a central stellate scar. Liver function is normal and she has never used oral contraceptives. What is the appropriate management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Observation without surgery

Focal nodular hyperplasia is a benign hyperplastic response to an arterial malformation, with a central stellate scar. It has no malignant potential and rarely bleeds or ruptures, so asymptomatic lesions are observed. Surgery is considered only for symptoms or diagnostic doubt.

Option by option

  • A. Segmental hepatic resection

    Resection is not required because the lesion is benign and seldom complicates.

  • B. Observation without surgery (correct)

    Correct. Asymptomatic focal nodular hyperplasia is a benign lesion that needs no treatment.

  • C. Percutaneous radiofrequency ablation

    Ablation is used for small malignant tumours such as hepatocellular carcinoma and is not needed for a benign lesion.

  • D. Transarterial chemoembolisation

    Chemoembolisation treats hepatocellular carcinoma and has no role in a benign lesion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Observation without surgery. Focal nodular hyperplasia is a benign hyperplastic response to an arterial malformation, with a central stellate scar.

Why is "Segmental hepatic resection" not the answer?

Resection is not required because the lesion is benign and seldom complicates.

Why is "Percutaneous radiofrequency ablation" not the answer?

Ablation is used for small malignant tumours such as hepatocellular carcinoma and is not needed for a benign lesion.

Why is "Transarterial chemoembolisation" not the answer?

Chemoembolisation treats hepatocellular carcinoma and has no role in a benign lesion.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: focal nodular hyperplasia in General Surgery. It has no malignant potential and rarely bleeds or ruptures, so asymptomatic lesions are observed. Surgery is considered only for symptoms or diagnostic doubt.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hepatobiliary and pancreatic surgery: focal nodular hyperplasia?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.