What Is Hepatocellular Adenoma?
Hepatocellular adenoma is a rare benign tumor of liver cells. More common in women, the age of onset is mostly 30 to 50 years old.
- Visiting department
- Oncology
- Multiple groups
- More common in women
- Common causes
- Mostly related to oral contraceptives
- Common symptoms
- There is an epigastric mass when the tumor is enlarged
- Contagious
- no
Basic Information
Causes of hepatocellular adenoma
- This disease is related to oral contraceptives and can also occur in patients with estrogen hormone therapy, long-term use of anticonvulsant carbamazepine, glycogen storage disease, and sexual hormone disorders.
Clinical manifestations of hepatocellular adenoma
- Early tumors are small without any clinical symptoms and are often found during physical examination or laparotomy. As the course of the disease progresses, the tumor gradually grows, and some patients may have a lump in the upper abdomen. The surface of the lump is smooth and hard, and there is no tenderness. When the tumor grows to a certain degree, compression symptoms such as epigastric distension, fullness after eating, and nausea may occur. Intratumoral bleeding may occur in some cases, manifested as right upper quadrant pain with fever, right upper quadrant tenderness, and abdominal muscle tension, which is easily misdiagnosed as Acute cholecystitis. Approximately one-third of patients with hepatocellular adenoma may develop spontaneous rupture and cause massive intra-abdominal hemorrhage. In severe cases, they may cause hemorrhagic shock and endanger life.
Hepatocellular adenoma examination
- 1. Ultrasound examination showed a clear echo enhancement zone with a clear boundary, uneven internal echo distribution, and stronger echo spots visible inside.
2. CT inspection (1) plain scan. Intrahepatic low-density or equal-density mass lesions, bleeding and calcification can be irregular high-density, the edges are smooth, and "transparent ring" shadows can be seen around them, which are often characteristic features, usually liver cells that are squeezed around the tumor Caused by increased internal fat vacuoles.
(2) Enhancement. In the early stage, the homogeneity was enhanced, and after that, the density decreased to the same density as normal liver tissue; in the later stage, the density was low. There was no enhancement of the "clear ring" around the tumor.
(3) Malignant tumors can present large lobular masses or large ring-dead areas with occasional calcifications.
3. Histopathological examination: Tumors are usually single, most of them are round, covered with membrane, and vary in size. The tumor cells were slightly larger than normal hepatocytes under the microscope, and vacuoles were formed. The interstitial cells were capillaries and connective tissue.
Hepatocellular adenoma diagnosis
- For women of childbearing age who have found intrahepatic mass lesions on imaging studies and have had oral contraceptives for more than 5 years, they have clinical symptoms of abdominal pain, hepatomegaly, and abdominal mass. They are generally in good condition, have no history of hepatitis, and have normal liver function. Consider the possibility of hepatocellular adenoma. Fine-needle aspiration cytology can be clearly diagnosed but there is a possibility of bleeding, which can be considered in the case of normal coagulation function.
Hepatocellular adenoma treatment
- Surgical resection is the preferred treatment. Depending on the size, number, and location of the tumor, a corresponding liver lobe, liver segment, or local resection is performed. If the tumor is adjacent to the first and second hepatic hilum, or is close to the large blood vessels and bile ducts, when surgical resection is difficult, ligation of the hepatic artery or the inherent hepatic artery can be performed to reduce the blood supply to the tumor, limit the further growth of the tumor, and prevent rupture Bleeding.