Hepatocellular adenoma in advanced-stage fatty liver disease

Hepatocellular adenomas are defined as benign hepatocellular neoplasms occurring in otherwise near normal liver and adenomatosis as 10 or more such lesions. We present a case of a 45-year-old man with radiological adenomatosis, histologically confirmed with resection of one lesion, arising within advanced-stage nonalcoholic fatty liver disease (nearly cirrhotic). Hepatocellular adenomas have recently been divided into four categories and the lesion in the present case had morphologic and immunohistochemical features of an inflammatory hepatocellular adenoma. These findings demonstrate that, in contrast to the current dogma, nodules within advanced-stage liver disease may rarely be best classified as adenomas. This should be considered in the radiological differential diagnosis when assessing a patient's suitability for transplantation.