An Extreme Case of Liver Adenomatosis: Are They All the Same?
Hepatocellular adenoma (HCA) is a rare and benign liver tumor that affects predominantly young and middle-aged women, especially between 30–40 years old. Liver adenomatosis (LA) is defined as the presence of 10 or more HCA. There are authors that report eight different subtypes of HCA, that correlat...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Gastroenterology Insights |
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| Online Access: | https://www.mdpi.com/2036-7422/13/1/8 |
| _version_ | 1797471506091999232 |
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| author | Carolina Chálim Rebelo Diogo Bernardo Moura Margarida Flor de Lima Eduardo Dutra Rui Amaral José Renato Pereira Maria Antónia Duarte |
| author_facet | Carolina Chálim Rebelo Diogo Bernardo Moura Margarida Flor de Lima Eduardo Dutra Rui Amaral José Renato Pereira Maria Antónia Duarte |
| author_sort | Carolina Chálim Rebelo |
| collection | DOAJ |
| description | Hepatocellular adenoma (HCA) is a rare and benign liver tumor that affects predominantly young and middle-aged women, especially between 30–40 years old. Liver adenomatosis (LA) is defined as the presence of 10 or more HCA. There are authors that report eight different subtypes of HCA, that correlates with clinical and histopathological features, being the inflammatory subtype the most common. We present a case of a 32-year-old Caucasian woman with a history of self-limited episodes of right abdominal pain and an abdominal ultrasound with multiple hypoechogenic liver nodules, suspected of metastasis. She was taking combined oral contraceptive for 6 years. Magnetic Resonance Imaging (MRI) disclosed around 40 nodules, suggestive of HCA. Liver biopsy confirmed HCA, inflammatory subtype. Oral contraceptive was stopped and control MRI 6 months later disclosed reduction of nodules’ dimensions. Management of patients with LA should be based on the size of the largest tumor, as clinical presentation and risk of bleeding or malignancy do not differ between patients with single or multiple HCAs. However, even with biopsy, there is a risk of missampling, raising concern about the real risk of bleeding and malignant potential in patients with different subtypes coexisting in the same liver. |
| first_indexed | 2024-03-09T19:49:15Z |
| format | Article |
| id | doaj.art-70f193d1ec9e4dabb0e6682db3351411 |
| institution | Directory Open Access Journal |
| issn | 2036-7414 2036-7422 |
| language | English |
| last_indexed | 2024-03-09T19:49:15Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Gastroenterology Insights |
| spelling | doaj.art-70f193d1ec9e4dabb0e6682db33514112023-11-24T01:15:57ZengMDPI AGGastroenterology Insights2036-74142036-74222022-02-01131687610.3390/gastroent13010008An Extreme Case of Liver Adenomatosis: Are They All the Same?Carolina Chálim Rebelo0Diogo Bernardo Moura1Margarida Flor de Lima2Eduardo Dutra3Rui Amaral4José Renato Pereira5Maria Antónia Duarte6Gastroenterology Department, Hospital Divino Espírito Santo de Ponta Delgada, 9500-307 Ponta Delgada, PortugalGastroenterology Department, Hospital Divino Espírito Santo de Ponta Delgada, 9500-307 Ponta Delgada, PortugalGastroenterology Department, Hospital Divino Espírito Santo de Ponta Delgada, 9500-307 Ponta Delgada, PortugalPathology Department, Curry Cabral Hospital, Central Lisbon University Hospital Center, Nova Medical School, Nova University, 1050-099 Lisbon, PortugalRadiology Deparment, Hospital Divino Espírito Santo de Ponta Delgada, 9500-307 Ponta Delgada, PortugalGastroenterology Department, Hospital Divino Espírito Santo de Ponta Delgada, 9500-307 Ponta Delgada, PortugalGastroenterology Department, Hospital Divino Espírito Santo de Ponta Delgada, 9500-307 Ponta Delgada, PortugalHepatocellular adenoma (HCA) is a rare and benign liver tumor that affects predominantly young and middle-aged women, especially between 30–40 years old. Liver adenomatosis (LA) is defined as the presence of 10 or more HCA. There are authors that report eight different subtypes of HCA, that correlates with clinical and histopathological features, being the inflammatory subtype the most common. We present a case of a 32-year-old Caucasian woman with a history of self-limited episodes of right abdominal pain and an abdominal ultrasound with multiple hypoechogenic liver nodules, suspected of metastasis. She was taking combined oral contraceptive for 6 years. Magnetic Resonance Imaging (MRI) disclosed around 40 nodules, suggestive of HCA. Liver biopsy confirmed HCA, inflammatory subtype. Oral contraceptive was stopped and control MRI 6 months later disclosed reduction of nodules’ dimensions. Management of patients with LA should be based on the size of the largest tumor, as clinical presentation and risk of bleeding or malignancy do not differ between patients with single or multiple HCAs. However, even with biopsy, there is a risk of missampling, raising concern about the real risk of bleeding and malignant potential in patients with different subtypes coexisting in the same liver.https://www.mdpi.com/2036-7422/13/1/8liver adenomatosishepatocellular adenomainflammatory subtypeliver nodules |
| spellingShingle | Carolina Chálim Rebelo Diogo Bernardo Moura Margarida Flor de Lima Eduardo Dutra Rui Amaral José Renato Pereira Maria Antónia Duarte An Extreme Case of Liver Adenomatosis: Are They All the Same? Gastroenterology Insights liver adenomatosis hepatocellular adenoma inflammatory subtype liver nodules |
| title | An Extreme Case of Liver Adenomatosis: Are They All the Same? |
| title_full | An Extreme Case of Liver Adenomatosis: Are They All the Same? |
| title_fullStr | An Extreme Case of Liver Adenomatosis: Are They All the Same? |
| title_full_unstemmed | An Extreme Case of Liver Adenomatosis: Are They All the Same? |
| title_short | An Extreme Case of Liver Adenomatosis: Are They All the Same? |
| title_sort | extreme case of liver adenomatosis are they all the same |
| topic | liver adenomatosis hepatocellular adenoma inflammatory subtype liver nodules |
| url | https://www.mdpi.com/2036-7422/13/1/8 |
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