Spontaneous hepatocellular adenoma in paediatric age group - case report

Hepatocellular adenoma (Hca) is a rare, benign, liver cell tumour. Hca is most frequently seen in women with a history of oral contraceptive use. Hca is also reported in children with glycogen storage disorders, galactosaemia, Hurler's syndrome, severe immune deficiency states, diabetes mellitus, sex hormone disturbances, Fanconis anaemia, in those who are on androgen therapy and also in seizure disorder patients who are on carbamazepine therapy. Usually, Hca arises typically in a clinical setting of hormonal or metabolic abnormalities which stimulate hepatocyte proliferation. Though it is rare, a few cases of spontaneous Hca have been reported in children and also in adults, which were not associated with any of the known risk factors which are associated with Hca. Hca has to be differentiated from focal nodular hyperplasia, hepatocellular carcinoma and hepatoblastoma. The histological features and the assessment of cell proliferation by using immuno histochemistry, help in confirming the diagnosis of Hca. In a few cases of Hca, malignant transformations have been reported. Hence, a careful search for malignant transformations is necessary. In this report, we have documented two cases of spontaneous Hca which occurred in two normal children.