Hepatocellular adenoma
| Hepatocellular adenoma | |
|---|---|
| Specialty | Gastroenterology, oncology  |
Hepatocellular adenoma, also hepatic adenoma, or rarely hepadenoma, is an uncommon benign liver tumor which is associated with the use of hormonal contraception with a high estrogen content.[1] Patients taking higher potency hormones, patients of advanced age, or patients with prolonged duration of use have a significantly increased risk of developing hepatocellular adenomas.[2]
Diagnosis
MRI is the most useful investigation in the diagnosis and work-up.[3] . CT may also be used to diagnose hepatic adenomas.
Large hepatic adenomas have a tendency to rupture and bleed massively inside the abdomen.
Radiologic differential diagnosis
Pathologic diagnosis
Hepatic adenoma are, typically, well-circumscribed nodules that consist of sheets of hepatocytes with a bubbly vacuolated cytoplasm. The hepatocytes are on a regular reticulin scaffold and less or equal to three cell thick.
The histologic diagnosis of hepatic adenomas can be aided by reticulin staining. In hepatic adenomas, the reticulin scaffold is preserved and hepatocytes do not form layers of four or more hepatocytes, as is seen in hepatocellular carcinoma.
Etiology
Ninety percent of hepatic adenomas arise in women aged 20-40, most of whom use oral contraceptives.
Related Conditions
Hepatic adenomas are related to glycogen storage diseases, type 1, as well as anabolic steroids.
Treatment
All hepatocellular adenoma should be resected, because of the risk of rupture causing bleeding and because they may contain malignant foci.[4]
Additional images
References
- ^ Rooks J, Ory H, Ishak K, Strauss L, Greenspan J, Hill A, Tyler C (1979). "Epidemiology of hepatocellular adenoma. The role of oral contraceptive use". JAMA. 242 (7): 644–8. doi:10.1001/jama.242.7.644. PMID 221698.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ "Hepatocellular Adenoma: eMedicine Gastroenterology".
{{cite web}}: Cite has empty unknown parameter:|coauthors=(help) - ^ Hussain S, van den Bos I, Dwarkasing R, Kuiper J, den Hollander J (2006). "Hepatocellular adenoma: findings at state-of-the-art magnetic resonance imaging, ultrasound, computed tomography and pathologic analysis". Eur Radiol. 16 (9): 1873–86. doi:10.1007/s00330-006-0292-4. PMID 16708218.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ 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.
{{cite journal}}: CS1 maint: multiple names: authors list (link)Full text
External links
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