Inferior caval vein thrombosis owing to compression of focal nodular hyperplasia: surgical resection after shrinkage by hepatic artery embolization.

The purpose of this study was to investigate the results of a staged treatment of symptomatic focal nodular hyperplasia (FNH), consisting of first embolization and then resection. A 36-year-old woman presented with pulmonary embolism caused by an inferior caval vein thrombosis owing to external compression by FNH in liver segment I (5.2 x 6.7 cm). She was treated with anticoagulants. The FNH lesion was first reduced by radiologic embolization of the feeding branch of the right hepatic artery. A 41% size reduction was obtained, and the symptoms disappeared. FNH resection was performed 5(1/2) months later. The thrombus had disappeared, and the anticoagulant therapy could be stopped perioperatively. A symptomatic FNH lesion was treated successfully in two stages.