Adenomatous hyperplastic nodules in the cirrhotic liver: a therapeutic approach. Work in progress

Adenomatous hyperplastic nodules (AHNs) in the cirrhotic liver may be precurosors of hepatocellular carcinoma. These nodules have been demonstrated more frequently because of the increased use of ultrasonography (US) in the screening of high-risk patients. Treatment is a problem because surgical resection of a precancerous lesion is considered by some to be unadvisable in patients with high surgical risk. The authors used percutaneous ethanol injection with US guidance in five patients with AHNs that measured 1.4-2.6 cm. A total of 30 injections were performed, without complications. Lesions were undetectable or were reduced in size on follow-up US scans. All biopsies yielded necrotic material. No recurrences have been demonstrated with US after 9-21 months. Percutaneous ethanol injection is therefore proposed as a therapeutic alternative for small AHNs.