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

Diagnosis

Treatment

References

  1. 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. 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. 3.0 3.1 Radiopaedia 2015 Hepatic adenoma>"Radiopedia 2015 Hepatic adenoma [Dr Matt A. Morgan and Dr Koshy Jacob]".
  4. 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.
  5. 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. Hepatocellular adenoma. USPSTF. http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=hepatocellular+adenoma


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