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A hepatic adenoma (also called hepatocellular adenoma) is a rare growth of the liver. It is most often seen in women, usually those that are on oral contraceptives or during pregnancy. The tumor is benign in nature so it does not metastasize to other parts of the body. There are very few symptoms associated with a hepatic adenoma and its discovery is almost always incidental.

Treatment of hepatic adenoma

The approach to the treatment of a hepatic adenoma is usually conservative. The size of the adenoma and the sub-classification of the kind of growth being seen help in deciding the exact treatment plan.

  • Stopping oral contraceptive pills

Estrogen based oral contraceptive drugs are believed to be the main risk-factor behind the occurrence of a hepatic adenoma. The longer such drugs are taken, the larger becomes the risk of developing hepatic adenoma.

For growths that are less than 2 inches in size, the doctor may choose not to do anything at all and simply advise a cessation of the oral contraceptive pills. This helps in a decrease of the size of the adenoma.

The tumor will then be monitored over a period of time to track its growth, if any. A small percentage of small hepatic adenomas actually disappear on their own.

  • Surgery

For a large hepatic adenoma, your doctor may advise surgery to remove the tumor. The larger hepatic adenomas are found to be at a higher risk of developing malignancies down the road. There is also a higher risk of bleeding, spontaneous rupture, and mortality to the patients who develop large hepatic adenomas.

Surgery is not limited to just large hepatic adenomas, though. Men who develop hepatic adenoma (small or large) are usually treated with surgery because the risk of malignancy is believed to be much higher.

Women who cannot stop taking birth control pills are also advised to go for surgery because the risk of the lesion enlarging is quite high.

There are certain proteins which are tested for that help in the sub-classification of hepatic adenomas. Inflammatory type of hepatic adenoma or the β-catenin activated type of hepatic adenoma are usually treated through the surgical route.

Complications of Hepatic Adenomas

All of the following complications are found more commonly in large hepatic adenoma growths and this is why they are treated more aggressively.

The most serious complication associated with a hepatic adenoma is of spontaneous rupture. This can lead to internal bleeding, severe abdominal pain, and even death. If a ruptured hepatic adenoma is suspected then it must be treated as a medical emergency.

The other, much less common, complication is the occurrence of malignancy. Tumors that have been classified as the β-catenin activated types are believed to be at the highest chance of turning malignant.

Conclusion

A hepatic adenoma is a rare growth of the liver. The lack of symptoms associated with it makes it difficult to diagnose at an early stage. While the tumor is benign, there are several serious complications associated with it. As mentioned earlier, the larger the adenoma, the more aggressive is the treatment approach.

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