Hepatocellular adenoma (patient information)

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Hepatocellular adenoma

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Hepatocellular adenoma?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

Hepatocellular adenoma On the Web

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Images of Hepatocellular adenoma

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Blogs on Hepatocellular adenoma

Directions to Hospitals Treating Hepatocellular adenoma

Risk calculators and risk factors for Hepatocellular adenoma

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

Hepatocellular adenoma is an uncommon benign liver adenoma that is most commonly associated with oral contraceptive use in women of childbearing age. It is generally asymptomatic, the typical clinical manifestations include spontaneous rupture or hemorrhage leading to acute abdominal pain with progression to hypotension and even death. There are no specific physical examination findings associated with adenoma. It is more commonly seen in western countries where they are exposed to higher doses of oral contraceptive medications. The estimated incidence is 3 per 1,000,000/year and is 3 to 4 per 100,000 with long term oral contraceptive use. Hepatocellular adenomas are classified on the basis of molecular patterns called phenotypic genotypic classification into 04 groups including; HNF1 alpha inactivated adenoma, beta catenin activated adenoma, inflammatory hepatic adenoma and unclassified type adenoma. The gold standard method for diagnosis of hepatocellular adenoma is excision biopsy of the liver lesions either by surgery or laparoscopically. There is no specific medical therapy for the adenoma, wait & watch policy is recommended for hepatocellular adenomas <5 cm following cessation of oral contraceptives. Annual followup with MRI or ultrasound is recommended until menopause. Surgical resection is the treatment of choice for adenomas that are >5 cm in diameter, that increase in size, lesions with intra tumoral hemorrhage and male patients (irrespective of the adenoma size). The radiofrequency ablation (RFA) and transcatheter arterial embolization (TAE) may be tried in patients who are poor candidates for surgery.

What are the symptoms of Hepatocellular adenoma?

Small hepatocellular adenomas are generally asymptomatic.

What causes Hepatocellular adenoma?

Who is at highest risk?

Risk factors for malignant transformation

The risk factor for malignant transformation of hepatic adenoma to hepatocellular carcinoma is:

Diagnosis

  • If a liver tumor is suspected, your doctor might suggest tests to identify the tumor and its cause. They might also suggest tests to rule out other potential diagnoses.
  • An ultrasound is often one of the first steps your doctor will take to help them make a diagnosis. If your doctor finds a large mass through an ultrasound, additional tests might be required to confirm that the mass is a hepatic adenoma.
  • Other imaging tests, such as CT scans and MRIs, can be used to learn more about the tumor.
  • If the tumor is large, your doctor might also suggest a biopsy. During a biopsy, a small tissue sample is removed from the mass and evaluated under a microscope.

Treatment options

Medical Therapy

Surgical Therapy

Where to find medical care for Hepatocellular adenoma?

Directions to Hospitals Treating Hepatocellular adenoma

Prevention of Hepatocellular adenoma

An annual follow-up with MRI or ultrasound may be scheduled for female patients until menopause, when the adenoma is < 5cm or regress to < 5cm after discontinuation of oral contraceptive medications.

What to expect (Outlook/Prognosis)?

Possible complications

  • When left untreated, hepatic adenomas can rupture spontaneously. This can cause abdominal pain and internal bleeding. A ruptured hepatic adenoma requires immediate medical treatment.
  • In rare cases, untreated hepatic adenomas can become cancerous. This is more likely when the tumor is large.
  • Several studies suggest that β-catenin activated hepatic adenomas are more likely to become cancerous. Additional research is needed to understand the link between hepatic adenoma types and cancer.

Source

  1. 1.0 1.1 Barthelmes L, Tait IS (2005). "Liver cell adenoma and liver cell adenomatosis". HPB (Oxford). 7 (3): 186–96. doi:10.1080/13651820510028954. PMC 2023950. PMID 18333188.
  2. Toso C, Majno P, Andres A, Rubbia-Brandt L, Berney T, Buhler L, Morel P, Mentha G (2005). "Management of hepatocellular adenoma: solitary-uncomplicated, multiple and ruptured tumors". World J Gastroenterol. 11 (36): 5691–5. PMID 16237767.Full text
  3. Ault GT, Wren SM, Ralls PW, Reynolds TB, Stain SC (1996). "Selective management of hepatic adenomas". Am Surg. 62 (10): 825–9. PMID 8813164.

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