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Current Approaches in the Management of Hepatic Adenomas

Diamantis I Tsilimigras1, Amir A Rahnemai-Azar2, Ioannis Ntanasis-Stathopoulos3

  • 1Laboratory of Experimental Surgery and Surgical Research, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|August 16, 2018
PubMed

Insights

Hepatic adenomas (HAs), benign liver tumors, have distinct subtypes influencing management. Key factors for surgical consideration include size, subtype, and gender, with specific approaches for hemorrhage and malignant transformation.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Oncology

Background:

  • Hepatic adenomas (HAs) are rare, benign liver neoplasms.
  • Understanding HA subtypes is crucial for diagnosis and management.

Purpose of the Study:

  • To review the diagnosis, evaluation, and therapeutic management of hepatic adenomas.
  • To highlight recent advances in molecular classification and their clinical implications.

Main Methods:

  • Comprehensive literature review of English-language studies.
  • Databases searched included MEDLINE/PubMed and Web of Science up to April 2018.
  • Keywords focused on hepatocellular, hepatic, liver, adenoma, and adenomatosis.

Main Results:

  • Molecular classification reveals distinct HA subtypes with unique characteristics.
  • Regression may occur with hormonal cessation or weight loss.
  • Surgical resection is indicated for symptomatic patients or those with hemorrhage/malignant transformation risk factors (e.g., >5 cm, β-catenin activation, male gender).
  • Hemorrhage management involves angioembolization and resection; malignant transformation requires oncologic resection.
  • Pregnancy does not contraindicate HA presence.

Conclusions:

  • Further genomic studies are needed for evidence-based, individualized HA management.
  • Risk-adapted models are essential for guiding treatment strategies.
Abstract

Keywords:
AdenomaAdenomatosisHNF-1αHepaticJAK-STAT pathwayLiverβ-Catenin

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