Massive hepatic adenoma response to bland embolization: A case study

Abstract

Hepatic adenomas are rare, benign liver masses of rising incidence in the United States. We present a report of a 22-year-old asymptomatic female with a massive (14.2 × 11.4 cm), centrally located hepatic adenoma. The unique presentation of the adenoma in close proximity to the hepatic vasculature meant the patient was not a candidate for surgical resection. An arterial embolization was used as an alternative approach to initial treatment. Arterial branches supplying the adenoma were identified via computed tomography and embolized with embospheres and coils. The treatment resulted in a large reduction in size and density of the adenoma identified at a 1-month follow-up. The case supports further use of arterial embolization as an initial treatment for large adenomas to improve the outcome of subsequent surgical approaches.

Liver Transplantation for Treatment of Unresectable Spontaneous Ruptured Hepatocellular Adenoma: A Rare Indication

“…However, considering the high risk of morbidity and mortality with emergent surgery, TAE should be considered to stabilize the patient, and the liver resection should be delayed to an elective procedure. Also, some authors have suggested that TAE can reduce or even lead to the disappearance of some tumors [1][2][4][5][6][7][8]10,15].…”

“…Hepatocellular Adenoma (HA) are benign liver tumor with an incidence of 1-4 per 1000,000 adults per year [1]. They are most common in women of reproductive age, and the incidence is 30 times higher in oral contraceptive users [2,3].…”

Challenging Issues in Hepatic Adenoma

“…For small lesions, TAE can achieve complete resolution and thus avoidance of liver surgery entirely. TAE may be also used as means to shrink the tumors to a size that renders them approachable for subsequent surgical resection [76]. TAE can reduce the size of large adenomas, multiple adenomas, or adenomas that are in a surgical inaccessible localization alleviating the symptoms and reducing the risk of perioperative bleeding.…”