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Hepatic Adenoma
Ethan A. Smith, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Hepatocellular adenoma (HCA)
          • Definitions

            • Benign neoplasm arising from hepatocytes
            • Different subtypes with different imaging features & clinical significance
              • Inflammatory ~ 40-50%
              • Hepatocyte nuclear factor 1α (HNF1α) mutated ~ 30-35%
                • More frequently have fat content
              • β-catenin activated ~ 10-15%
                • ↑ malignant potential
                • More common in males
              • Unclassified ~ 5-10%

          IMAGING

          • General Features

            • Ultrasonographic Findings

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Natural History & Prognosis

                              • Treatment

                                Selected References

                                1. DiPaola F et al: Congenital portosystemic shunts in children: associations, complications, and outcomes. Dig Dis Sci. 65(4):1239-51, 2020
                                2. Fang C et al: Contrast-enhanced ultrasound in the diagnosis of pediatric focal nodular hyperplasia and hepatic adenoma: interobserver reliability. Pediatr Radiol. 49(1):82-90, 2019
                                3. Trout AT et al: Hepatocyte-specific contrast media: not so simple. Pediatr Radiol. 48(9):1245-55, 2018
                                4. Dhingra S et al: Update on the new classification of hepatic adenomas: clinical, molecular, and pathologic characteristics. Arch Pathol Lab Med. 138(8):1090-7, 2014
                                5. Katabathina VS et al: Genetics and imaging of hepatocellular adenomas: 2011 update. Radiographics. 31(6):1529-43, 2011
                                6. van Aalten SM et al: Hepatocellular adenomas: correlation of MR imaging findings with pathologic subtype classification. Radiology. 261(1):172-81, 2011
                                7. Chung EM et al: From the archives of the AFIP: pediatric liver masses: radiologic-pathologic correlation part 1. Benign tumors. Radiographics. 30(3):801-26, 2010
                                8. Das CJ et al: Imaging of paediatric liver tumours with pathological correlation. Clin Radiol. 64(10):1015-25, 2009
                                9. Jha P et al: Pediatric liver tumors--a pictorial review. Eur Radiol. 19(1):209-19, 2009
                                10. Laumonier H et al: Hepatocellular adenomas: magnetic resonance imaging features as a function of molecular pathological classification. Hepatology. 48(3):808-18, 2008
                                11. Siegel MJ et al: Pediatric liver: focal masses. Magn Reson Imaging Clin N Am. 16(3):437-52, v, 2008
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Clinical Issues

                                        TERMINOLOGY

                                        • Synonyms

                                          • Hepatocellular adenoma (HCA)
                                        • Definitions

                                          • Benign neoplasm arising from hepatocytes
                                          • Different subtypes with different imaging features & clinical significance
                                            • Inflammatory ~ 40-50%
                                            • Hepatocyte nuclear factor 1α (HNF1α) mutated ~ 30-35%
                                              • More frequently have fat content
                                            • β-catenin activated ~ 10-15%
                                              • ↑ malignant potential
                                              • More common in males
                                            • Unclassified ~ 5-10%

                                        IMAGING

                                        • General Features

                                          • Ultrasonographic Findings

                                            • CT Findings

                                              • MR Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Gross Pathologic & Surgical Features

                                                        • Microscopic Features

                                                          CLINICAL ISSUES

                                                          • Natural History & Prognosis

                                                            • Treatment

                                                              Selected References

                                                              1. DiPaola F et al: Congenital portosystemic shunts in children: associations, complications, and outcomes. Dig Dis Sci. 65(4):1239-51, 2020
                                                              2. Fang C et al: Contrast-enhanced ultrasound in the diagnosis of pediatric focal nodular hyperplasia and hepatic adenoma: interobserver reliability. Pediatr Radiol. 49(1):82-90, 2019
                                                              3. Trout AT et al: Hepatocyte-specific contrast media: not so simple. Pediatr Radiol. 48(9):1245-55, 2018
                                                              4. Dhingra S et al: Update on the new classification of hepatic adenomas: clinical, molecular, and pathologic characteristics. Arch Pathol Lab Med. 138(8):1090-7, 2014
                                                              5. Katabathina VS et al: Genetics and imaging of hepatocellular adenomas: 2011 update. Radiographics. 31(6):1529-43, 2011
                                                              6. van Aalten SM et al: Hepatocellular adenomas: correlation of MR imaging findings with pathologic subtype classification. Radiology. 261(1):172-81, 2011
                                                              7. Chung EM et al: From the archives of the AFIP: pediatric liver masses: radiologic-pathologic correlation part 1. Benign tumors. Radiographics. 30(3):801-26, 2010
                                                              8. Das CJ et al: Imaging of paediatric liver tumours with pathological correlation. Clin Radiol. 64(10):1015-25, 2009
                                                              9. Jha P et al: Pediatric liver tumors--a pictorial review. Eur Radiol. 19(1):209-19, 2009
                                                              10. Laumonier H et al: Hepatocellular adenomas: magnetic resonance imaging features as a function of molecular pathological classification. Hepatology. 48(3):808-18, 2008
                                                              11. Siegel MJ et al: Pediatric liver: focal masses. Magn Reson Imaging Clin N Am. 16(3):437-52, v, 2008