Hepatocellular adenoma medical therapy: Difference between revisions
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{{CMG}}; {{AE}} {{ZAS}} | {{CMG}}; {{AE}} {{ZAS}} | ||
==Overview== | ==Overview== | ||
There is no specific medical [[therapy]] for | There is no specific [[Medicine|medical]] [[therapy]] for hepatocellular adenoma. The wait-and-watch policy is recommended for hepatocellular adenomas < 5 cm following cessation of offending [[Drug|drugs]] ([[Oral contraceptive|OCPs]]) with no further [[growth]] detected. An annual follow-up with [[Magnetic resonance imaging|MRI]] or [[ultrasound]] is scheduled for [[female]] [[Patient|patients]] untill [[menopause]]. | ||
== | ==Medical Therapy== | ||
* There is no specific medical [[therapy]] for | * There is no specific [[Medicine|medical]] [[therapy]] for hepatocellular adenoma.<ref name="cde">{{cite journal | author = Toso C, Majno P, Andres A, Rubbia-Brandt L, Berney T, Buhler L, Morel P, Mentha G | title = Management of hepatocellular adenoma: solitary-uncomplicated, multiple and ruptured tumors. | journal = World J Gastroenterol | volume = 11 | issue = 36 | pages = 5691-5 | year = 2005 | id = PMID 16237767}}''[http://www.wjgnet.com/1007-9327/11/5691.asp Full text]''</ref><ref name="pmid8813164">{{cite journal| author=Ault GT, Wren SM, Ralls PW, Reynolds TB, Stain SC| title=Selective management of hepatic adenomas. | journal=Am Surg | year= 1996 | volume= 62 | issue= 10 | pages= 825-9 | pmid=8813164 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8813164 }} </ref> | ||
* Historically, | * Historically, hepatocellular adenomas were treated with a wait-and-watch policy, with [[Surgery|surgical intervention]] recommended for larger (> 5 cm) [[Tumor|tumors]]. | ||
* In [[asymptomatic]] female | * In [[asymptomatic]] [[female]] [[Patient|patients]], the first step is to stop the offending [[drug]] (such as [[Oral contraceptive|OCPs]]) and follow-up to document any change in the size of the [[tumor]]. | ||
* The wait and watch policy is recommended when | * The wait-and-watch policy is recommended when the tumor is < 5 cm in size or when it has [[Regression|regressed]] (to < 5 cm) following cessation of the offending [[drug]] ([[Oral contraceptive|OCPs]]) with no further [[growth]] detected.<ref>{{Cite journal | ||
| author = [[Maarten G. Thomeer]], [[Mirelle Broker]], [[Joanne Verheij]], [[Michael Doukas]], [[Turkan Terkivatan]], [[Diederick Bijdevaate]], [[Robert A. De Man]], [[Adriaan Moelker]] & [[Jan N. IJzermans]] | | author = [[Maarten G. Thomeer]], [[Mirelle Broker]], [[Joanne Verheij]], [[Michael Doukas]], [[Turkan Terkivatan]], [[Diederick Bijdevaate]], [[Robert A. De Man]], [[Adriaan Moelker]] & [[Jan N. IJzermans]] | ||
| title = Hepatocellular adenoma: when and how to treat? Update of current evidence | | title = Hepatocellular adenoma: when and how to treat? Update of current evidence | ||
| Line 21: | Line 21: | ||
| pmid = 27803743 | | pmid = 27803743 | ||
}}</ref> | }}</ref> | ||
* An annual follow-up with [[Magnetic resonance imaging|MRI]] or [[ultrasound]] is scheduled for [[Patient|patients]] untill [[menopause]].<ref name="pmid18333188">{{cite journal| author=Barthelmes L, Tait IS| title=Liver cell adenoma and liver cell adenomatosis. | journal=HPB (Oxford) | year= 2005 | volume= 7 | issue= 3 | pages= 186-96 | pmid=18333188 | doi=10.1080/13651820510028954 | pmc=PMC2023950 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18333188 }} </ref><ref>{{Cite journal | * An annual follow-up with [[Magnetic resonance imaging|MRI]] or [[ultrasound]] is scheduled for [[female]] [[Patient|patients]] untill [[menopause]].<ref name="pmid18333188">{{cite journal| author=Barthelmes L, Tait IS| title=Liver cell adenoma and liver cell adenomatosis. | journal=HPB (Oxford) | year= 2005 | volume= 7 | issue= 3 | pages= 186-96 | pmid=18333188 | doi=10.1080/13651820510028954 | pmc=PMC2023950 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18333188 }} </ref><ref>{{Cite journal | ||
| author = [[A. F. Mariani]], [[A. S. Livingstone]], [[R. V. Jr Pereiras]], [[P. E. van Zuiden]] & [[E. R. Schiff]] | | author = [[A. F. Mariani]], [[A. S. Livingstone]], [[R. V. Jr Pereiras]], [[P. E. van Zuiden]] & [[E. R. Schiff]] | ||
| title = Progressive enlargement of an hepatic cell adenoma | | title = Progressive enlargement of an hepatic cell adenoma | ||
Latest revision as of 01:54, 23 August 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zahir Ali Shaikh, MD[2]
Overview
There is no specific medical therapy for hepatocellular adenoma. The wait-and-watch policy is recommended for hepatocellular adenomas < 5 cm following cessation of offending drugs (OCPs) with no further growth detected. An annual follow-up with MRI or ultrasound is scheduled for female patients untill menopause.
Medical Therapy
- There is no specific medical therapy for hepatocellular adenoma.[1][2]
- Historically, hepatocellular adenomas were treated with a wait-and-watch policy, with surgical intervention recommended for larger (> 5 cm) tumors.
- In asymptomatic female patients, the first step is to stop the offending drug (such as OCPs) and follow-up to document any change in the size of the tumor.
- The wait-and-watch policy is recommended when the tumor is < 5 cm in size or when it has regressed (to < 5 cm) following cessation of the offending drug (OCPs) with no further growth detected.[3]
- An annual follow-up with MRI or ultrasound is scheduled for female patients untill menopause.[4][5][6][7][8][9][10]
References
- ↑ 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
- ↑ Ault GT, Wren SM, Ralls PW, Reynolds TB, Stain SC (1996). "Selective management of hepatic adenomas". Am Surg. 62 (10): 825–9. PMID 8813164.
- ↑ 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) - ↑ 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.
- ↑ A. F. Mariani, A. S. Livingstone, R. V. Jr Pereiras, P. E. van Zuiden & E. R. Schiff (1979). "Progressive enlargement of an hepatic cell adenoma". Gastroenterology. 77 (6): 1319–1325. PMID 499719. Unknown parameter
|month=ignored (help) - ↑ P. H. Andersen & J. T. Packer (1976). "Hepatic adenoma. Observations after estrogen withdrawal". Archives of surgery (Chicago, Ill. : 1960). 111 (8): 898–900. PMID 182106. Unknown parameter
|month=ignored (help) - ↑ S. Kay (1977). "Nine year follow-up of a case of benign liver cell adenoma related to oral contraceptives". Cancer. 40 (4): 1759–1760. PMID 198104. Unknown parameter
|month=ignored (help) - ↑ P. Aseni, C. V. Sansalone, C. Sammartino, F. D. Benedetto, G. Carrafiello, A. Giacomoni, C. Osio, M. Vertemati & D. Forti (2001). "Rapid disappearance of hepatic adenoma after contraceptive withdrawal". Journal of clinical gastroenterology. 33 (3): 234–236. PMID 11500616. Unknown parameter
|month=ignored (help) - ↑ H. Buhler, M. Pirovino, A. Akobiantz, J. Altorfer, M. Weitzel, E. Maranta & M. Schmid (1982). "Regression of liver cell adenoma. A follow-up study of three consecutive patients after discontinuation of oral contraceptive use". Gastroenterology. 82 (4): 775–782. PMID 6277724. Unknown parameter
|month=ignored (help) - ↑ B. Heeringa & A. Sardi (2001). "Bleeding hepatic adenoma: expectant treatment to limit the extent of liver resection". The American surgeon. 67 (10): 927–929. PMID 11603546. Unknown parameter
|month=ignored (help)