| Hepatocellular adenoma | |
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| Classification and external resources | |
Micrograph of a hepatic adenoma (bottom of image). H&E stain. |
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| ICD-O: | M8170/0 |
| DiseasesDB | 5726 |
| eMedicine | med/48 |
| MeSH | D018248 |
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]
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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.
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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.
Cells resemble normal hepatocytes and are traversed by blood vessels but lack portal tracts or central veins.
Ninety percent of hepatic adenomas arise in women aged 20–40, most of whom use oral contraceptives.
Hepatic adenomas are related to glycogen storage diseases, type 1, as well as anabolic steroids.
Some authors feel that all hepatocellular adenoma should be resected, because of the risk of rupture causing bleeding and because they may contain malignant foci.[4]. However, the majority of experts feel that lesions less than 5 cm should merely be observed with serial imaging. Patients with adenomas should avoid oral contraceptives or hormonal replacement therapy.
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