Hepatocellular adenomas in men: MRI findings in four patients

Abstract

Purpose: To demonstrate both MRI and histopathological findings of hepatocellular adenomas (HCAs) in men. Materials and Methods:HCAs in four men are reported. All patients underwent MR studies at 1.5T including serial gadolinium-enhanced gradient echo imaging. Results:Three men had solitary non-hemorrhagic adenomas that exhibited a uniform capillary blush with no central scar, and uniform fading of the tumor to near isointensity with the liver parenchyma by one minute. One of the subjects had uniform fat content as shown by uniform low signal on out-of-phase images. One patient had a solitary hemorrhagic adenoma that measured 17 cm in diameter and was heterogeneous on all sequences. Two of the four patients had a history of anabolic steroid use, and in the other two patients no underlying explanation for the tumor was found.Conclusions: Although three of the four patients had tumors that exhibited uniform homogeneous tumor blush and rapid fading of enhancement, because HCAs are rare in men and resemble hepatocellular carcinoma (HCC) in appearance, our findings suggest that histological confirmation of HCAs may not be avoidable in men.

Hepatocellular Adenoma: Evaluation with Contrast-Enhanced Ultrasound and MRI and Correlation with Pathologic and Phenotypic Classification in 26 Lesions

“…The arterial enhancement is never strong on either MRI or CEUS, and vanished in the delayed phase. The slight arterial enhancement on CEUS and MRI can be explained by a focal compression of the sinusoids due to steatosis and a less important blood flow [16]. The marked hypointensity in the MRI delayed phase is related to the slight previous enhancement and the persistent gradient of signal between the liver and the nodule due to the fat saturation.…”

Testosterone-receptor positive hepatocellular carcinoma in a 29-year old bodybuilder with a history of anabolic androgenic steroid abuse: a case report

“…As has been described previously, HCA showed highly variable appearance on computed tomography (CT), magnetic resonance imaging (MRI), and contrast-enhanced ultrasound (CEUS) scans. This is reflected by the differences in the histological features [ 21 – 25 ]. In the CEUS, typical HCA shows an arterial hypervascularisation in the early arterial phase with a centripetal filling pattern.…”

Genotype-phenotype correlations in hepatocellular adenoma: an update of MRI findings

“…Most described cases of HCA in men occurred after the chronic intake of exogenous hormones (38) or in men with glycogen storage disease (39). Because of its low incidence, its diagnosis should be questioned, and we advise that a biopsy be performed more often when these tumors are found in men to exclude the presence of a premalignant or malignant liver tumor.…”