A Scoping Review of the Classification, Diagnosis, and Management of Hepatic Adenomas

Hassan Aziz; Zachary J Brown; Mariam F Eskander; Christopher T Aquina; Azarakhsh Baghdadi; Ihab R Kamel; Timothy M Pawlik

doi:10.1007/s11605-022-05246-8

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A Scoping Review of the Classification, Diagnosis, and Management of Hepatic Adenomas

Journal article

Peer reviewed

A Scoping Review of the Classification, Diagnosis, and Management of Hepatic Adenomas

Hassan Aziz, Zachary J Brown, Mariam F Eskander, Christopher T Aquina, Azarakhsh Baghdadi, Ihab R Kamel and Timothy M Pawlik

Journal of gastrointestinal surgery, Vol.26(4), pp.965-978

04/01/2022

DOI: 10.1007/s11605-022-05246-8

PMID: 35083725

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Abstract

Hepatic adenomas (HA), or hepatocellular adenomas, are benign, solid liver lesions that develop in otherwise normal livers, often in the setting of increased estrogen levels. While considered a benign tumor, there is a risk for substantial complications such as hemorrhage and malignant transformation. We review the diagnosis, classification, and potential therapeutic management options for patients with HA. A scoping narrative review was conducted based on recent literature regarding classification, diagnosis, and management of HA. While HAs are typically considered benign, complications such as hemorrhage and malignant transformation may occur in approximately 25% and 5% of patients, respectively. Recent advances in imaging and molecular profiling have allowed for the classification of HAs into subtypes allowing for patient risk stratification that helps guide management. Surgical resection should be considered in asymptomatic patients who are male, have an adenoma ≥5 cm in diameter, or have the β-catenin-activated subtype due to an increased risk of hemorrhage and/or malignant transformation. Molecular profiling has aided in the stratification of patients relative to the risk of complications to predict better the potential behavior of HAs.

Adenoma - complications

Adenoma - diagnosis

Adenoma - therapy

Adenoma, Liver Cell - diagnosis

Adenoma, Liver Cell - pathology

Adenoma, Liver Cell - therapy

Cell Transformation, Neoplastic - pathology

Female

Hemorrhage - etiology

Humans

Liver Neoplasms - diagnosis

Liver Neoplasms - pathology

Liver Neoplasms - therapy

Male

Details

Title: Subtitle: A Scoping Review of the Classification, Diagnosis, and Management of Hepatic Adenomas
Creators: Hassan Aziz - Tufts University
Zachary J Brown - The Ohio State University Wexner Medical Center
Mariam F Eskander - The Ohio State University Wexner Medical Center
Christopher T Aquina - The Ohio State University Wexner Medical Center
Azarakhsh Baghdadi - Johns Hopkins University
Ihab R Kamel - Johns Hopkins University
Timothy M Pawlik - The Ohio State University Wexner Medical Center
Resource Type: Journal article
Publication Details: Journal of gastrointestinal surgery, Vol.26(4), pp.965-978
DOI: 10.1007/s11605-022-05246-8
PMID: 35083725
ISSN: 1091-255X
eISSN: 1873-4626
Language: English
Date published: 04/01/2022
Academic Unit: Surgery
Record Identifier: 9984701555502771

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