Safety and Outcomes of Percutaneous Biopsy of 61 Hepatic Adenomas

Given the recent classification of hepatic adenoma (HA) into subtypes and recognition of imperfect specificity of MRI to differentiate HA from focal nodular hyperplasia (FNH), there is a resurgent interest in the role of biopsy to diagnose HA. The purpose of this study was to determine the safety and outcomes of biopsy of HAs.

A retrospective review of the electronic medical records of all patients who underwent hepatic mass biopsy revealing HA from 2000 through 2013 was performed. The biopsy procedure parameters were evaluated. Complications were graded using the Common Terminology Criteria for Adverse Events. Pathology-specific outcomes related to the diagnosis of HA were assessed.

Sixty patients (52 women and eight men) were identified with a mean age of 42 ± 13 (SD) years and a mean follow-up of 2.3 ± 3.0 years after biopsy. One patient had two HAs biopsied during the same procedure, resulting in a total of 61 biopsy-proven HAs. Of the 60 patients, one patient (2%) had a single major complication, which involved bleeding that resulted in a blood transfusion, and six patients (10%) had a minor complication. A total of six (10%) discordant biopsy results were found: Four biopsy-proven HAs (7%) revealed FNH on surgical resection or repeat biopsy, one HA (2%) showed well-differentiated hepatocellular carcinoma (HCC) at subsequent biopsy, and one HA (2%) showed findings suggestive of HCC on follow-up imaging.

Complications after biopsy of HAs are uncommon. Although uncommon, discordant pathology results between biopsy and surgical resection may occur.