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PET-avid hepatocellular adenomas: incidental findings associated with HNF1-α mutated lesions
Ser Yee Lee1, T Peter Kingham2, Maria D LaGratta3
1Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.
Background:
Hepatocellular adenoma (HCA) is the second most common benign liver neoplasm and occurs predominantly in women in their reproductive years. Positron emission tomography (PET) using [18F] fluorodeoxyglucose (FDG) is commonly used in cancer staging, surveillance and evaluation of treatment response. PET-avid HCA are rare and can be falsely interpreted as malignancies.
Methods:
A retrospective review of four institutions' database was performed to identify the PET-avid HCAs with clinico-pathological correlation.
Results:
Nine patients with histological proven PET-avid HCA was identified. Eight out of 9 patients were female with a median age at diagnosis of 44 years. All patients' tumors with available histological subtyping (8/8) were HNF1-α mutated and had no inflammatory changes; 6 out the 9 lesions had prominent (>50%) steatotic changes.
Conclusion:
Hepatocellular adenomas, specifically the HNF1-α subtype, can cause false-positive PET findings when seeking to identify malignancy. Concomitantly, PET-CT may have the potential to identify the HCA histopathologic variant with the lowest malignant and hemorrhagic potential.
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