Hepatic Adenoma (HA)
A hepatic adenoma (HA) is a benign tumor of the liver that is found rarely and affects mostly women in their 20’s or 30’s, with an approximate male-to-female ratio of 1 to 4.
There are two types of hepatic adenoma: those HA that are originated in the bile ducts (these usually have a diameter of less than 1 centimeter and doesn’t represent a clinical risk), and the HA that are originated in liver cells (which are larger, with a typical diameter ranging from 8 to 15 centimeters, although 30cm tumors have been observed, and most or the times is clinically significant).
A hepatic adenoma (HA) is usually circumscribed to a well defined region within the affected organ. It is often a solitary tumor, but in rare cases several HA may be present. Rarely, an HA can evolve into a malign form of tumor.
Causes Of Hepatic Adenoma
Hepatic adenoma is suspected to be a consequence of several years of use of oral contraceptives in women. It is known that the longer the duration of use of oral contraceptives, the more the risk of developing hepatic adenoma. It is also known that users of oral contraceptives that already have HA usually have larger tumors and risk of tumor rupture.
Adenoma also may occur in people with type-Ia glycogen storage disease, usually associated with insulin-dependant diabetes.
Symptoms Of Hepatic Adenoma
Typically, small hepatic adenomas are asymptomatic and usually discovered “by accident” while performing other tests or treatments for other diseases. On the other hand, when hepatic adenoma is large enough, hepatomegaly (abnormal enlargement of the liver) may be observed, and bleeding is present on most cases. On some very rare occasions, bleeding is large enough to cause hemorrhagic shock.
Hepatic adenoma usually represents a diagnosis challenge for doctors, because it is difficult to differentiate between a hepatic adenoma and a malign tumor. The pain in the upper quadrant of the liver is identical to that produced by cholecystitis, and both conditions are easily mistaken.
Treatment Of Hepatic Adenoma
Stopping the ingestion of oral contraceptives can in most cases cause a hepatic adenoma to decrease its size. For relatively large adenomas, surgery is the preferred treatment. The fact that hepatic adenoma can, in rare cases, suffer a malignant transformation and turn into hepatocellular carcinoma (HCC) is the main reason to recommend surgical removal and resection. Surgery is also recommended if risk of a massive hemorrhage due to rupture is suspected. For smaller hepatic adenoma cases, however, there is usually no need for treatment as they don’t constitute a risk.
Prevention Of Hepatic Adenoma
Making the right choice regarding the use of a contraception method is closely related to prevention of hepatic adenoma. Also, keeping diabetes under control and following healthy food habits may prevent hepatic adenoma, as well as other liver diseases.