Hepatocellular adenoma surgery

Jump to: navigation, search

Hepatocellular adenoma Microchapters


Patient Information


Historical Perspective




Differentiating Hepatocellular adenoma from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings



Echocardiography and Ultrasound

CT scan


Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hepatocellular adenoma surgery On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides


American Roentgen Ray Society Images of Hepatocellular adenoma surgery

All Images
Echo & Ultrasound
CT Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hepatocellular adenoma surgery

CDC on Hepatocellular adenoma surgery

Hepatocellular adenoma surgery in the news

Blogs on Hepatocellular adenoma surgery

Directions to Hospitals Treating Hepatocellular adenoma

Risk calculators and risk factors for Hepatocellular adenoma surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Zahir Ali Shaikh, MD[3]


Surgical resection is the treatment of choice for hepatocellular adenoma larger than 5 cm in diameter, the ones that increase in size, lesions with intra-tumoral hemorrhage, and male patients (irrespective of the adenoma size). Liver transplantation may be considered for hepatocellular adenomas associated with glycogen storage disease type 1. Radiofrequency ablation (RFA) and transcatheter arterial embolization (TAE) may be considered for patients who are poor candidates for surgery.


Approach to the Management of Hepatocellular Adenoma Based on Clinical Features, Gender, Imaging Features, and Histology:

MRI features of hepatic adenoma
Male & glycogen storage disease
Hemodynamically stable
Hemodynamically unstable
Resection irrespective of size & subtype
Stop offending drugs
Radiofrequency ablation resection
Embolization resection
< 5 cm
> 5 cm
Steatotic (HNF1 a) Hepatic adenoma
Inflammatory hepatic adenoma
Beta catenin hepatic adenoma
Consider resection
Followup, genetic counselling for MODY & hepatic adenomatosis
Close followup, treatment of obesity
Biopsy & resection if confirmed
Biopsy & treat based on subtype


  1. Paulette Bioulac-Sage, Herve Laumonier, Gabrielle Couchy, Brigitte Le Bail, Antonio Sa Cunha, Anne Rullier, Christophe Laurent, Jean-Frederic Blanc, Gaelle Cubel, Herve Trillaud, Jessica Zucman-Rossi, Charles Balabaud & Jean Saric (2009). "Hepatocellular adenoma management and phenotypic classification: the Bordeaux experience". Hepatology (Baltimore, Md.). 50 (2): 481–489. doi:10.1002/hep.22995. PMID 19585623. Unknown parameter |month= ignored (help)
  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.
  4. T. Terkivatan, J. H. de Wilt, R. A. de Man, R. R. van Rijn, H. W. Tilanus & J. N. IJzermans (2001). "Treatment of ruptured hepatocellular adenoma". The British journal of surgery. 88 (2): 207–209. doi:10.1046/j.1365-2168.2001.01648.x. PMID 11167868. Unknown parameter |month= ignored (help)
  5. J. Belghiti, D. Pateron, Y. Panis, V. Vilgrain, J. F. Flejou, J. P. Benhamou & F. Fekete (1993). "Resection of presumed benign liver tumours". The British journal of surgery. 80 (3): 380–383. PMID 8472159. Unknown parameter |month= ignored (help)
  6. Jan P. Lerut, Olga Ciccarelli, Christine Sempoux, Etienne Danse, Jacques deFlandre, Yves Horsmans, Etienne Sokal & Jean-Bernard Otte (2003). "Glycogenosis storage type I diseases and evolutive adenomatosis: an indication for liver transplantation". Transplant international : official journal of the European Society for Organ Transplantation. 16 (12): 879–884. doi:10.1007/s00147-003-0613-3. PMID 12904843. Unknown parameter |month= ignored (help)
  7. Maarten G. Thomeer, Mirelle Broker, Joanne Verheij, Michael Doukas, Turkan Terkivatan, Diederick Bijdevaate, Robert A. De Man, Adriaan Moelker & Jan N. IJzermans (2016). "Hepatocellular adenoma: when and how to treat? Update of current evidence". Therapeutic advances in gastroenterology. 9 (6): 898–912. doi:10.1177/1756283X16663882. PMID 27803743. Unknown parameter |month= ignored (help)