Long-term follow-up of hepatic adenoma and adenomatosis: analysis of size change on imaging with histopathological correlation

Abstract

Most adenomas were either stable or regressed on follow-up. Size change was independent of baseline size. After an initial size decrease within 5 years, no further size reduction was noted on extended follow-up. The percent size change in the HA-H and HA-I subtype was similar.

Regression of multiple hepatocellular adenomas after cessation of oral contraceptive pills : a case report and review of the current literature

“…growing or arising in male patients (who are more at risk for malignant transformation irrespective of size) (1,4). The risks of bleeding and malignant transformation are estimated to be 5% and 2% respectively in small HCA (< 5 cm) and 25% and 9%, for HCA > 5 cm (10). There is no difference between single HCAs or multiple HCAs (11).…”

“…The association between the use of OCP and the development of HCA and an increased risk of bleeding is well described and seems to be dose-dependent (6). Compared to single HCAs the development of multiple HCAs are more frequently seen in OCP users and in patients with obesity and steatosis (10).…”

“…Furthermore, most series included both single and multiple HCAs which complicates the interpretation. An overview of the current literature about the evolution of multiple HCAs and correlation with the different subtypes is presented in table 2 (5,8,(10)(11)(12). Information about the impact of OCP withdrawal on the different subtypes is scarce.…”

“…Information about the impact of OCP withdrawal on the different subtypes is scarce. A retrospective study of 44 patients by Shao et al (10), indicated that lesions with important fat infiltration (characteristic for H-HCA) showed a significant less size decrease after OCP cessation compared to those without fat infiltration. The team of Klompenhouwer et al (13) found a difference for HCA regression in different subtypes, in favour of I-HCA and unclassified HCA, although in a retrospective study of 134 patients no statistically significant differences could be found (12).…”

Updates on The Management of Hepatocellular Adenomas

“…Women with tumors < 5cm in diameter will undergo surveillance by annual MRI [24]. In a retrospective review of MRI and CT scan studies of 44 patients with liver adenoma or adenomatosis who underwent imaging surveillance, maximum regression of the tumors was detected within 5 years and the tumor stabilized afterward [26]. The interval between follow-up MRIs can be increased to biannual after 5 years.…”