Changing Epidemiology of Hepatocellular Adenoma in the United States: Review of the Literature

Chang, Charissa; Hernández-Prera, Juan C.; Roayaie, Sasan; Schwartz, Myron; Thung, Swan N.

doi:10.1155/2013/604860

Cited by 88 publications

(62 citation statements)

References 37 publications

(47 reference statements)

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“…Newer generation contraceptive pills with lower estrogen content are likely associated with a lower risk of hepatic adenomas. Despite that, the overall incidence of hepatic adenomas has not decreased 58 . This can perhaps be explained by the increasing rates of obesity worldwide and an associated increase in metabolic syndrome, with a subset of those patients being diagnosed with hepatic adenomas, particularly the inflammatory and telangiectatic variant 55, 59 .…”

Section: Clinical and Radiologic Features Of The Common Liver Mass Lementioning

confidence: 99%

Liver Masses: A Clinical, Radiologic, and Pathologic Perspective

Venkatesh

Chandan

Roberts

2014

Clinical Gastroenterology and Hepatology

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Liver masses present a relatively common clinical dilemma, particularly with the increasing use of various imaging modalities in the diagnosis of abdominal and other symptoms. The accurate and reliable determination of the nature of the liver mass is critical, not only to reassure individuals with benign lesions but also, and perhaps more importantly, to ensure that malignant lesions are diagnosed correctly. This avoids the devastating consequences of missed diagnosis and the delayed treatment of malignancy or the unnecessary treatment of benign lesions With appropriate interpretation of the clinical history and physical examination, and the judicious use of laboratory and imaging studies, the majority of liver masses can be characterized noninvasively. Accurate characterization of liver masses by cross-sectional imaging is particularly dependent on an understanding of the unique phasic vascular perfusion of the liver and the characteristic behaviors of different lesions during multiphasic contrast imaging. When non-invasive characterization is indeterminate, a liver biopsy may be necessary for definitive diagnosis. Standard histologic examination is usually complemented by immunohistochemical analysis of protein biomarkers. Accurate diagnosis allows the appropriate selection of optimal management, which is frequently reassurance or intermittent follow up for benign masses. For malignant lesions or those at risk of malignant transformation, management depends on the tumor staging, the functional status of the uninvolved liver and technical surgical considerations. Unresectable metastatic masses require oncologic consultation and therapy. The efficient characterization and management of liver masses therefore requires a multidisciplinary collaboration between the gastroenterologist/hepatologist, radiologist, pathologist, hepatobiliary or transplant surgeon, and medical oncologist.

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Section: Clinical and Radiologic Features Of The Common Liver Mass Lementioning

confidence: 99%

Liver Masses: A Clinical, Radiologic, and Pathologic Perspective

Venkatesh

Chandan

Roberts

2014

Clinical Gastroenterology and Hepatology

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“…Discoveries of benign hepatocellular nodules including hepatocellular adenoma (HCA) and focal nodular hyperplasia (FNH) have increased due to the widespread use of imaging modalities as well as the recent increase in obesity in people . HCA are rare benign hepatocellular tumors reported to occur frequently in women taking oral contraceptives . In addition, glycogen storage disease and a specific form of diabetes (maturity‐onset diabetes of the young type 3, MODY3) are also indicated in its etiology .…”

Section: Introductionmentioning

confidence: 99%

Preserved or enhanced OATP1B3 expression in hepatocellular adenoma subtypes with nuclear accumulation of β‐catenin

Fukusato

Soejima

Kondo

et al. 2014

Hepatology Research

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Aim Recent studies have indicated that hepatocellular adenoma (HCA) is a heterogenous group of benign tumors with various genetic and clinicopathological characteristics. We delineated the clinicopathological characteristics of HCA subtypes and evaluated the expression of transporter protein OATP1B3 in HCA. Methods HCA in 34 Japanese patients were investigated immunohistochemically and classified into four subtypes (HNF1α‐inactivated type, H‐HCA; β‐catenin‐activated type, b‐HCA; inflammatory type, I‐HCA; unclassified type, u‐HCA). Immunostaining of OATP1B3 protein in HCA tissue sections was performed to determine the association between OATP1B3 expression and HCA subtypes. Results HCA was categorized into the following four subtypes and two combined subtypes: 10 H‐HCA (29%), 10 I‐HCA (29%), seven b‐HCA (21%), two b‐HCA/H‐HCA (6%), two b‐HCA/I‐HCA (6%) and three u‐HCA (9%). The male‐to‐female ratio was 18:16. Oral contraceptive use was rare but seven HCA were found in patients with glycogen storage disease, congenital absence of the portal vein and idiopathic portal hypertension. OATP1B3 expression was decreased in 24 HCA but was preserved or increased in 10 HCA. All nine HCA with nuclear staining for β‐catenin showed preserved or enhanced OATP1B3 expression, indicating a significant association between nuclear β‐catenin accumulation and OATP1B3 expression in HCA. Conclusion HCA subtype classification was validated in 91% of our Japanese subjects although their clinical backgrounds including rare contraceptive use were different from European subjects. A close association between preserved or enhanced OATP1B3 expression and b‐HCA subtype indicated important modalities for clinical decisions in the treatment and follow up of patients with HCA.

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“…Given the high number of patients with non cirrhotic NAFLD, screening for HCC in this population is not practicable [15] . Interestingly, the features of NAFLD-related HCC are similar to those of HCC of obese patients and of non-cirrhotic HCC, independently of the etiology [92,93] . Accordingly, it has been reported that obese patients have a relative risk of liver cancer of 189% relative to the 117% of overweight subjects [94] .…”

Section: Hcc In Nafld Chronic Hepatitismentioning

confidence: 84%

Fat and hepatocellular carcinoma

Balsano¹,

Porcu²,

Sideri³

et al. 2018

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Obesity and diabetes are associated with the onset of hepatocellular carcinoma (HCC). These two illnesses correlate also with the development of non-alcoholic fatty liver disease (NAFLD). Currently, NAFL is considered the leading form of chronic liver disease in the Western industrialized countries. Insulin resistance is the common pathogenic factor among these three pathologies. NAFL is characterized by fat accumulation in the liver that involves greater than 5% of the liver parenchyma with no evidence of hepatocyte injury. However, NAFL may progress toward non-alcoholic steatohepatitis that in turn may lead to advanced fibrosis, cirrhosis and HCC. It is alarming that NAFLD related HCC has been, at present, considered as a growing burden worldwide, and its prevalence is tending to further increase together with the increasing incidence of obesity and diabetes. Worthy of note is that in the presence of chronic accumulation of fat in the liver it has been reported the emergence of HCC during chronic liver disease in absence of liver cirrhosis, usually the major risk factor for the development of HCC. Thus, in the future NAFLD related HCCs will place a growing strain on health-care systems from the need for their management. Unfortunately, most of the NAFLD related HCC patients are diagnosed at advanced stages and are characterized by a poor prognosis, because they are ineligible to radical treatments. Thus, it is urgent to boost up new screening policies to make early diagnoses, as well as to develop preventive-therapeutic strategies.

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Changing Epidemiology of Hepatocellular Adenoma in the United States: Review of the Literature

Cited by 88 publications

References 37 publications

Liver Masses: A Clinical, Radiologic, and Pathologic Perspective

Liver Masses: A Clinical, Radiologic, and Pathologic Perspective

Preserved or enhanced OATP1B3 expression in hepatocellular adenoma subtypes with nuclear accumulation of β‐catenin

Fat and hepatocellular carcinoma

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