Hepatic Adenomatosis: A Rare but Important Liver Disease With Severe Clinical Implications

Donato, Maren; Jahromi, Alireza Hamidian; Andrade, Ana Ines; Kim, Roger H.; Chaudhery, Shabnum Ilyas; Sangster, Guillermo

doi:10.9738/intsurg-d-14-00161.1

Cited by 13 publications

(17 citation statements)

References 19 publications

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“…It is possible to define the various categories of adenoma and establish the risk of progression to hepatocarcinoma via histological and immunohistochemical studies. Therefore, nuclear expression of a mutant form of the ß-catenin gene in adenomatous tissue is linked to malignancy and, therefore, is an indication for surgical resection (1,10). In this case, the histological study of the microbiopsy of the largest lesion confirmed that it was an adenoma.…”

Section: Case Reportmentioning

confidence: 99%

“…Hepatic adenomatosis (HA) is a benign and uncommon disease defined as the presence of at least ten adenomas in a healthy liver (1). Although the cause is still unknown, HA has been related to hormonal treatments, storage diseases, vascular anomalies and conditions associated with a familial predisposition such as inherited errors of metabolism or maturity onset diabetes of the young (MODY).…”

Section: Introductionmentioning

confidence: 99%

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Nonalcoholic steatohepatitis and hepatic adenomatosis: casual or causal relationship?

et al. 2017

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Hepatic adenomatosis is a benign disease defined as the presence of multiple adenomas in a normal liver. It is an uncommon condition and there are less than a hundred reported cases in the literature. The etiology is unknown, although it has been associated with the use of oral contraceptives, anabolic steroids, certain storage diseases and some genetic mutations linked to maturity onset diabetes of the young.The coexistence of hepatic adenomatosis and nonalcoholic steatohepatitis has been recently described in two patients suffering from metabolic syndrome. This association is particularly interesting due to the growing prevalence of nonalcoholic fatty liver disease in developed countries and the possibility of a common causal pathway.We report the case of a young woman with fructosemia and hepatic steatosis; multiple hepatic adenomas associated to steatohepatitis lesions were also found during clinical follow-up. The possible implications are discussed.

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Section: Case Reportmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nonalcoholic steatohepatitis and hepatic adenomatosis: casual or causal relationship?

et al. 2017

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“…Radiofrequency ablation or embolization in these patients was successful in some authors' experience [74]. Liver adenomatosis becomes an indication for liver transplantation if there is evidence of malignant transformation or complications [75]. Observing these changes is possible only if patients are carefully followed on a regular basis with imaging.…”

Section: Algorithm 2 Management In Liver Adenomatosismentioning

confidence: 99%

Challenging Issues in Hepatic Adenoma

Boeți¹,

Tivadar²,

Lupescu³

et al. 2019

Liver Disease and Surgery [Working Title]

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Hepatic adenoma is known as a benign lesion encountered mainly in female patients and classically linked to the administration of oral contraceptives. In the last decade, the risk factors for its occurrence have changed and so did the sex ratio. The histopathological classification of hepatic adenomas was found to be related with certain genetic mutations that determine the risk for malignancy. The diagnosis of hepatic tumor is correlated with clinical and imaging data in an effort not only to rule out other tumors but also to distinguish the subtype of adenoma, which is very important for the management of the patient. The ultimate diagnosis is established by pathologists by routine histopathological and specific immunohistochemical staining. There are two major issues that pathologists need to recognize: the presence of β-catenin gene mutation and/or malignant degeneration. The best imaging examination is considered to be MRI. However, along with MRI, ultrasound and computer tomography have proved themselves to be effective not only in evaluating the number, size, localization, and complications of hepatic adenomas, but also in identifying their subtype. A detailed presentation of characteristics of all groups of hepatic adenoma is provided. The means of management of hepatic adenomas are documented and decisional algorithm is explained, based on certain criteria.

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“…Hepatic adenomatosis (HA) was irst described by Flejou et al in 1985 [1,2]. De ined as presence of 10 or more adenomas in a normal liver [1,2]. Occurs in 10-24% of all patients with liver cell adenomas [2].…”

Section: Introductionmentioning

confidence: 99%

“…De ined as presence of 10 or more adenomas in a normal liver [1,2]. Occurs in 10-24% of all patients with liver cell adenomas [2]. Etiology is poorly understood and no de inite association with the use of OCPs (oral contraceptive pills) or steroids as noted in solitary liver cell adenomas [3].…”

Section: Introductionmentioning

confidence: 99%

Hepatic adenomatosis: A clinically challenging rare liver disease

Ramachandra¹

2018

Ann Clin Gastroenterol Hepatol

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43-year-old lady presented with incidentally discovered liver lesions while she was being managed for her complaints of menorrhagia. CT and MRI showed hepatomegaly with multiple lesions in both lobes of the liver with vascular element in the background of diffuse fatty infi ltration. Patient underwent laparoscopic core biopsy. Histopathology showed extensive steatosis, intracytoplasmic giant mitochondria and absence of portal tracts, features highly suggestive of hepatic adenomatosis. IHC staining showed membranous and cytoplasmic positivity in hepatocytes for B-catenin consistent with multiple hepatic adenomatosis. Hepatic adenomatosis is a new clinical entity in the hepatological practice characterized by the presence of 10 or more nodules in the liver known for its major complication of bleeding. Hepatic adenomatosis is managed by regular imaging and resection of large (> 5cm) superfi cial and painful adenomas along with liver function tests and tumor markers to rule out malignant transformation. However, the potential cure being the liver transplantation.

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Hepatic Adenomatosis: A Rare but Important Liver Disease With Severe Clinical Implications

Cited by 13 publications

References 19 publications

Nonalcoholic steatohepatitis and hepatic adenomatosis: casual or causal relationship?

Nonalcoholic steatohepatitis and hepatic adenomatosis: casual or causal relationship?

Challenging Issues in Hepatic Adenoma

Hepatic adenomatosis: A clinically challenging rare liver disease

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