Hepatocellular adenoma surgery: Difference between revisions
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* The wait and watch policy is recommended when hepatocellular adenomas are <5cm or regress (to <5cm) following cessation of offending drug (OCPs) and no further growth detected. | * The wait and watch policy is recommended when hepatocellular adenomas are <5cm or regress (to <5cm) following cessation of offending drug (OCPs) and no further growth detected. | ||
* An yearly followup with MRI or ultrasound is scheduled for patients untill menopause. | * An yearly followup with MRI or ultrasound is scheduled for patients untill menopause. | ||
Revision as of 01:36, 11 January 2019
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Hepatocellular adenoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Hepatocellular adenoma surgery On the Web |
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American Roentgen Ray Society Images of Hepatocellular adenoma surgery |
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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]
Overview
There is no specific medical therapy for the hepatocellular adenomas. The wait and watch policy is recommended for hepatocellular adenoams <5cm following cessation of offending drugs (OCPs) and no further growth detected. Annual followup is scheduled with MRI or ultrasound until menopause.
Hepatocellular adenoma surgery
- There is no specific medical therapy for the hepatocellular adenoma.[1][2]
- Historically, hepatocellular adenomas were treated with a wait and watch policy, with surgical intervention recommended for larger (>5cm) tumors.
- In asymptomatic female patients of hepatocellular adenomas , the first step is to stop the offending drug (OCPs) and check adenoma size on followup.
- The wait and watch policy is recommended when hepatocellular adenomas are <5cm or regress (to <5cm) following cessation of offending drug (OCPs) and no further growth detected.
- An yearly followup with MRI or ultrasound is scheduled for patients untill menopause.
| MRI features of hepatic adenoma | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Asymptomatic | Symptomatic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Male & glycogen storage disease | Female | Hemodynamically stable | Hemodynamically unstable | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Resection irrespective of size & sybtype | Stop offending drugs | Radiofrequency ablation resection | Embolization resection | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| <5cm | >5cm | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Steatotic (HNF1 a) Hepatic adenoma | Inflammatory hepatic adenoma | Beta catenin hepatic adenoma | Otehrs | Consider resection | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Followup, genetic counselling for MODY & hepatic adenomatosis | Close followup, treatment of obesity & discontinue obesity | Biopsy & resection if confirmed | Biopsy & treat based on subtype | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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.