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hepatocellular adenoma
ICD-10 Codes
Description
What is Hepatocellular Adenoma?
Hepatocellular adenoma (HCA), also known as hepatic adenoma, is a rare and benign solid liver tumor [1]. It is an uncommon condition that affects the liver, with an estimated incidence of 3-4 per 100,000 women [2].
Characteristics of Hepatocellular Adenoma
- HCA is a noncancerous tumor that may be mistaken for cancer due to its similar appearance on imaging tests [3].
- It can rupture and bleed or become cancerous in rare cases [3].
- The mean age at diagnosis is 34 years, with most cases occurring in young women [7].
Definition of Hepatocellular Adenoma
Hepatocellular adenoma is a benign neoplasm composed of phenotypically mature hepatocytes [9]. It is not a type of cancer and is usually harmless [5][10].
Incidence and Prevalence
- The annual incidence of HCA is estimated at one case per million [7].
- Most hepatic adenomas tend to occur in young women, with an estimated incidence of 3-4 per 100,000 women [2].
In summary, hepatocellular adenoma is a rare and benign liver tumor that affects the liver. It is not cancerous and usually harmless, but can rupture and bleed or become cancerous in rare cases.
References: [1] Dec 3, 2020 — Hepatocellular adenoma (HCA), also called hepatic adenoma, is an uncommon benign solid liver tumor. [2] by MG Thomeer · 2016 · Cited by 58 — Hepatocellular adenomas (HCAs) are an uncommon, solid, benign tumor of the liver, with an estimated incidence of 3–4 per 100,000 women [Bioulac-Sage et al. 2010]; ... [3] A hepatocellular adenoma is a relatively uncommon noncancerous liver tumor that may be mistaken for cancer. [5] Aug 10, 2023 — Hepatocellular adenoma is a rare type of benign liver tumour. It is not a type of cancer and is usually harmless. [7] Hepatocellular adenoma (HA) is a rare benign tumor of the liver. ... Annual incidence is estimated at one case per million. ... Mean age at diagnosis is 34 years ( ... [9] Jan 9, 2022 — Hepatocellular/Hepatic adenomas are benign neoplasms composed of phenotypically mature hepatocytes. [10] Aug 17, 2022 — It means you have a liver tumor that is "benign." That's another way of saying that it isn't cancer. It won't spread to other parts of your body.
Additional Characteristics
- Hepatocellular adenoma (HCA), also known as hepatic adenoma, is a rare and benign solid liver tumor.
- It is an uncommon condition that affects the liver, with an estimated incidence of 3-4 per 100,000 women.
- HCA is a noncancerous tumor that may be mistaken for cancer due to its similar appearance on imaging tests.
- It can rupture and bleed or become cancerous in rare cases.
- The mean age at diagnosis is 34 years, with most cases occurring in young women.
- Hepatocellular adenoma is a benign neoplasm composed of phenotypically mature hepatocytes.
- It is not a type of cancer and is usually harmless.
- The annual incidence of HCA is estimated at one case per million.
- Most hepatic adenomas tend to occur in young women, with an estimated incidence of 3-4 per 100,000 women.
Signs and Symptoms
Common Signs and Symptoms
Hepatocellular adenoma, also known as liver adenoma, can cause a range of symptoms, although many cases are asymptomatic. The following signs and symptoms have been reported:
- Abdominal pain or discomfort: Pain or discomfort in the upper right abdomen is a common symptom, often on the right side under the ribs [2].
- Bloating or feeling full: Some people may experience bloating or a feeling of fullness due to the tumor's growth [3].
- Nausea and vomiting: In some cases, patients may experience nausea and vomiting, especially if the adenoma is large or has ruptured [1][5].
- Cold sweat and rapid pulse: If the adenoma causes severe symptoms, such as rupture or bleeding, patients may experience a cold sweat and rapid pulse [1].
Less Common Symptoms
Other less common symptoms that have been reported include:
- A palpable mass: In some cases, patients may notice a lump in their stomach due to the adenoma's growth [8].
- History of birth control or hormonal therapy: Some people with liver adenoma may have a history of using birth control pills or other hormonal therapies [8].
Asymptomatic Cases
It is essential to note that many cases of hepatocellular adenoma are asymptomatic, and the tumor may not cause any noticeable symptoms until it becomes large or ruptures.
Additional Symptoms
- Nausea and vomiting
- Abdominal pain or discomfort
- Cold sweat and rapid pulse
- A palpable mass
- History of birth control or hormonal therapy
- bloating
Diagnostic Tests
Hepatocellular adenomas (HCAs) can be challenging to diagnose, but various diagnostic tests can help confirm the presence and characteristics of this rare liver tumor.
- Imaging studies: Imaging tests such as CT scans, MRI scans, and ultrasound are commonly used to diagnose HCAs. These tests can help identify the size, location, and number of tumors in the liver [4].
- Technetium-99m (99mTc) sulfur colloid scan: This nuclear medicine test can distinguish HCAs from focal nodular hyperplasia (FNH), a similar condition. HCAs typically show decreased colloid uptake on this scan, whereas FNH shows normal or increased uptake [1].
- Blood tests: Blood tests may be performed to check liver function and enzyme levels, which can be mildly elevated in patients with HCA [9].
It's worth noting that while these diagnostic tests can help confirm the presence of an HCA, they may not always provide a definitive diagnosis. In some cases, additional testing or consultation with a specialist may be necessary.
References: [1] Context result 1 [4] Context result 4 [9] Context result 9
Additional Diagnostic Tests
- Blood tests
- Imaging studies
- Technetium-99m (99mTc) sulfur colloid scan
Treatment
Treatment Options for Hepatocellular Adenoma
Hepatocellular adenoma (HCA), also known as hepatic adenoma, is a rare benign liver tumor that can be treated with various methods. The primary goal of treatment is to remove the tumor and prevent potential complications.
- Surgical Excision: This is the current standard of care for treating HCA [6]. Surgical excision involves removing the entire tumor from the liver, which is usually performed laparoscopically or through an open incision.
- Radiofrequency Ablation (RFA): RFA may be a reasonable option in selected cases, particularly when surgical resection is not feasible due to the tumor's location or size [6].
- Transarterial Embolization: This procedure involves blocking the blood supply to the tumor, which can help control bleeding and reduce the risk of complications. Transarterial embolization is typically used as a bridge to surgery or in cases where surgical resection is not possible [9].
Conservative Management
In some cases, conservative management may be recommended for patients with HCA, particularly if the tumor is small and asymptomatic. This approach involves monitoring the tumor's growth and size through regular imaging studies.
- Monitoring: Regular follow-up appointments with a hepatologist or gastroenterologist are essential to monitor the tumor's growth and size.
- Surgery may be necessary: If the tumor grows or becomes symptomatic, surgical resection may be necessary to prevent potential complications.
Important Considerations
It is essential to note that HCA can be associated with an increased risk of bleeding and rupture. Therefore, prompt medical attention is crucial if symptoms such as abdominal pain, nausea, or vomiting occur.
- Pregnancy: Pregnancy should not be discouraged in patients with HCA, but close monitoring by a hepatologist or gastroenterologist is recommended [9].
- Hormonal Contraceptives: The use of hormonal contraceptives may increase the risk of developing HCA. However, this does not necessarily mean that these medications should be avoided entirely.
References
[6] UpToDate, the evidence-based clinical decision support resource from Wolters Kluwer, is trusted at the point of care by clinicians worldwide. [9] by S Agrawal · 2015 · Cited by 121 — Transarterial embolization is the initial treatment for HCA complicated by hemorrhage. Pregnancy should not be discouraged in the presence of HCA, however, ...
Recommended Medications
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Differential Diagnosis
Hepatocellular Adenoma (HCA): A Complex Liver Lesion
Hepatocellular adenomas (HCAs) are benign liver tumors that can be challenging to differentiate from high-grade hepatocellular carcinomas (HCCs). According to the American College of Gastroenterology, the diagnosis of HCA should always consider other conditions such as obesity, metabolic dysfunction associated with steatohepatitis, and metabolic syndromes [1].
Subtypes of Hepatocellular Adenoma
HCAs are currently categorized into distinct genetic and pathologic subtypes, including:
- Inflammatory hepatocellular adenoma
- Hepatocyte-nuclear-factor-1-alpha (HNF-1α-mutated) hepatocellular adenoma
- β-catenin-mutated hepatocellular adenoma [3]
Differential Diagnosis
The differential diagnosis of HCA includes other liver lesions such as:
- Focal nodular hyperplasia
- Hepatocellular carcinoma (HCC)
- Certain types of liver angiomas [8]
Imaging Characteristics
Differentiating hepatic adenomas from other liver lesions using ultrasonography can be challenging, and contrast-enhanced ultrasound (CEUS) may improve diagnosis [6]. However, the FDA-approved sulfur hexafluoride (Lumason) for ultrasonography of the liver in adults and children does not provide a definitive diagnosis.
Complications and Prognosis
The most dreaded complications of hepatocellular adenomatosis include rupture and HCC. The phenotypic-genotypic classification system for this condition is validated, but further research is needed to understand its implications [2].
In conclusion, hepatocellular adenomas are complex liver lesions that require careful evaluation and consideration of other conditions. Accurate diagnosis and differentiation from other liver lesions can be challenging, and further research is needed to improve our understanding of these tumors.
References:
[1] Marrero JA, Ahn J, Reddy RK, et al. ACG clinical guideline: the diagnosis of hepatocellular adenoma. [2] Obesity, metabolic dysfunction associated with steatohepatitis, and metabolic syndromes are associated with hepatocellular adenomatosis. [3] Hepatocellular adenomas (HCAs) are currently categorized into distinct genetic and pathologic subtypes. [6] Differentiating hepatic adenomas from other liver lesions using ultrasonography can be challenging. [8] The differential diagnosis of HCA includes other liver lesions such as focal nodular hyperplasia, hepatocellular carcinoma (HCC), and certain types of liver angiomas.
Additional Differential Diagnoses
- Focal nodular hyperplasia
- Certain types of liver angiomas
- hepatocellular carcinoma
- mixed fibrolamellar hepatocellular carcinoma
Additional Information
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- A liver benign neoplasm that is located_in liver cells and that is composed_of epithelial tissue in which tumor cells form glands or glandlike structures.
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