Simultaneous Occurrence of Focal Nodular Hyperplasia and HNF1A-inactivated Hepatocellular Adenoma

Shih, Angela R.; Lauwers, Gregory Y.; Balabaud, Charles; Bioulac‐Sage, Paulette; Misdraji, Joseph

doi:10.1097/pas.0000000000000477

Cited by 10 publications

(5 citation statements)

References 27 publications

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“…In H‐HCA, growth can be due to the collision of adjacent nodules 105 . Collision of tumours between H‐HCA or IHCA and FNH has been observed 106,107 …”

Section: Hca In Particular Clinicopathological Contextsmentioning

confidence: 99%

Hepatocellular adenoma: what we know, what we do not know, and why it matters

et al. 2022

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Hepatocellular adenoma: what we know, what we do not know, and why it mattersIn the last two decades there has been significant progress in research on and diagnosis of hepatocellular adenoma (HCA), resulting in the establishment of a molecular and immunohistological HCA classification. This review aims to fine-tune the current expertise in order to enhance the histopathological diagnostic possibilities, by refining issues that are already known, addressing diagnostic difficulties, and identifying still unknown aspects of HCA. We discuss novel methods to identify HCA subtypes, in particular the sonic hedgehog HCAs and the interpretation of glutamine synthetase patterns for the recognition of b-cateninmutated HCAs. The major complications of HCAs, i.e. bleeding and malignant transformation, are considered, including the dilemmas of atypical and borderline lesions. HCAs in different clinical and geographical settings, e.g. pregnancy, cirrhosis and non-western countries, are also discussed. The natural history of the different HCA subtypes in relation to age, sex and risk factors is a feature that is still insufficiently investigated. This is also true for the risks of clinical bleeding and malignant transformation in association with HCA subtypes. As HCA is a relatively rare tumour, a multicentre and multidisciplinary approach across geographical boundaries will be the appropriate method to establish prospective programmes with which to identify, classify and manage HCAs, focusing on several aspects, e.g. aetiology, underlying liver disease, complications, regression, and growth. Updating what we know and identifying and addressing what we do not know matters for optimal patient management.

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“…In H‐HCA, growth can be due to the collision of adjacent nodules 105 . Collision of tumours between H‐HCA or IHCA and FNH has been observed 106,107 …”

Section: Hca In Particular Clinicopathological Contextsmentioning

confidence: 99%

Hepatocellular adenoma: what we know, what we do not know, and why it matters

et al. 2022

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“…Shih et al [ 28 ] made a left hepatectomy for a case with common features between FNH and HA and operate for the uncertainty of diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Concerning the surgical technique, the laparoscopic approach is relatively recent. Unfortunately, Shih et al [ 28 ] didn’t report this in their paper although they did the same procedure for a similar patient. Despite the lack of high-level evidence data (randomized control trials, meta-analysis), current literature about laparoscopic vs open liver surgery for benign tumors suggests an advantage for the minimal-invasive technique[ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Focal nodular hyperplasia associated with a giant hepatocellular adenoma: A case report and review of literature

Gaspar-Figueiredo¹,

Kefleyesus²,

Sempoux³

et al. 2021

WJH

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BACKGROUND Focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) are well-known benign liver lesions. Surgical treatment is usually chosen for symptomatic patients, lesions more than 5 cm, and uncertainty of diagnosis. CASE SUMMARY We described the case of a large liver composite tumor in an asymptomatic 34-year-old female under oral contraceptive for 17-years. The imaging work-out described two components in this liver tumor; measuring 6 cm × 6 cm and 14 cm × 12 cm × 6 cm. The multidisciplinary team suggested surgery for this young woman with an unclear HCA diagnosis. She underwent a laparoscopic left liver lobectomy, with an uneventful postoperative course. Final pathological examination confirmed FNH associated with a large HCA. This manuscript aimed to make a literature review of the current management in this particular situation of large simultaneous benign liver tumors. CONCLUSION The simultaneous presence of benign composite liver tumors is rare. This case highlights the management in a multidisciplinary team setting.

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“…An interesting scenario is the possibility of colliding nodules such as FNH and HCA. It is not rare to observe H‐HCA in the immediate proximity of FNH with occasional combined tumours leading to false interpretation of a mixed tumour, or even to a more problematic hypothesis namely, the transformation of an FNH into an HCA and finally into an HCC, that is unlikely.…”

Section: Discussionmentioning

confidence: 99%

Unexpected discovery of small HNF1α‐inactivated hepatocellular adenoma in pathological specimens from patients resected for liver tumours

Balabaud

Laurent²,

Bail

et al. 2018

Liver International

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Taken together, H-HCAs are more frequent than we initially supposed as micro and small HCAs cannot all be detected by routine ultrasound. Despite no information on the potential growth of these micro/small H-HCAs, there is no argument to stop oral contraceptives or to ask for a specific regular surveillance. The association of different subtypes of HCAs with focal nodular hyperplasia suggests they share or have common etiological factors.

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Simultaneous Occurrence of Focal Nodular Hyperplasia and HNF1A-inactivated Hepatocellular Adenoma

Cited by 10 publications

References 27 publications

Hepatocellular adenoma: what we know, what we do not know, and why it matters

Hepatocellular adenoma: what we know, what we do not know, and why it matters

Focal nodular hyperplasia associated with a giant hepatocellular adenoma: A case report and review of literature

Unexpected discovery of small HNF1α‐inactivated hepatocellular adenoma in pathological specimens from patients resected for liver tumours

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