Hepatic Adenoma

What is contraindicated for diagnosis?

Biopsy; risk of bleeding is 40%

What is a hepatic adenoma?

Uncommon Benign epithelial liver tumors

Treatment for ASYMPTOMATIC hepatic adenomas?

discontinue ocp careful observation repeat imaging serial AFP measurements

Identification

epigastric or ruq pain incidental finding on imaging patient collapses from rupture and intra-abdominal bleeding

Hepatic adenomas found where?

Right hepatic lobe

Histologic appearance?

-Sheets of enlarged adenoma cells containing glycogen and lipid -Small, regular cell nuclei -Absent hepatic architecture-missing septa, portal tracts, bile ductules

Diagnosis based on?

Clinical presentation Imaging studies Surgical resection

Common physical findings?

Palpable abdominal mass Hepatomegaly Jaundice

Morphology

Solitary mass

Treatment for SYMPTOMATIC hepatic adenomas?

Surgical Resection

What is recommended overall for hepatic adenomas?

Surgical resection due to risk for potential malignant transformation, rupture, and growth

Labs

_LFTs- usually normal, can be occasionally elevated _Alkaline Phosphatase and GGT commonly elevated in patients with bleeding or multiple adenomas _Alpha Fetoprotein-normal, unless malignant transformation of tumor has happened

Hepatic adenomas also seen in ?

anabolic androgen use glycogen storage disease pregnancy DM

Typical patients with hepatic adenoma?

young-middle aged women with long history of oral contraceptive use