Hepatocellular adenoma overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., PhD.
Overview
Hepatocellular adenoma is an uncommon benign liver tumour which is associated with the use of hormonal contraception with a high estrogen content.[1]
Historical Perspective
Hepatocellular adenoma was first discovered by Edmondson in 1958 following 50,000 autopsies.[2]
Classification
Hepatocellular adenoma may be classified into four subtypes based on rate of occurence.[3]
Pathophysiology
On gross pathology, well circumscribed, nonlobulated,[4] smooth and soft, white to yellow to brown lesions, are characteristic findings of a solitary hepatocellular adenoma.[2]
Causes
The most common cause of hepatocellular adenoma is oral contraceptive use.[2]
Epidemiology and Demographics
The incidence of hepatic adenoma is approximately 3 per 100,000 individuals worldwide.[2]
Risk factors
The most potent risk factor in the development of hepatocellular adenoma is use of oral contraceptive pills.[5]
Screening
According to the United States Preventive Services Task Force, there is insufficient evidence to recommend routine screening for hepatocellular adenoma.[6]
Differentiating Hepatocellular adenoma from other Diseases
Hepatocellular adenoma must be differentiated from other diseases such as hepatocellular carcinoma (HCC), focal nodular hyperplasia (FNH), liver metastases (hypervascular), haemangioma of the liver, fibrolamellar hepatocellular carcinoma.[3] ===Natural History, Complications and Prognosis===If left untreated, 30% of patients with hepatocellular adenoma may progress to develop risk of bleeding.[6]Common complication of Hepatocellular adenoma includes spontaneous rupture, haemorrhage[3][7]and malignant transformation to Hepatocellular carcinoma.[7]
Diagnosis
Treatment
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. PMID 221698.
- ↑ 2.0 2.1 2.2 2.3 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.
- ↑ 3.0 3.1 3.2 Radiopaedia 2015 Hepatic adenoma>"Radiopedia 2015 Hepatic adenoma [Dr Matt A. Morgan and Dr Koshy Jacob]".
- ↑ Grazioli L, Federle MP, Brancatelli G, Ichikawa T, Olivetti L, Blachar A (2001). "Hepatic adenomas: imaging and pathologic findings". Radiographics. 21 (4): 877–92, discussion 892-4. doi:10.1148/radiographics.21.4.g01jl04877. PMID 11452062.
- ↑ How do oral contraceptives affect liver cancer risk. National Cancer Institute 2015. http://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/oral-contraceptives-fact-sheet
- ↑ 6.0 6.1 Hepatocellular adenoma. USPSTF. http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=hepatocellular+adenoma
- ↑ 7.0 7.1 Aamann L, Schultz N, Fallentin E, Hamilton-Dutoit S, Vogel I, Grønbæk H (2015). "[Hepatocellular adenoma - new classification and recommendations]". Ugeskr Laeger. 177 (12). PMID 25786843.