Adenoma hepatocelular con captación de 18 flúor deoxiglucosa en PET-TC SCAN. Una "mini-review" e informe de un nuevo caso / 18-fluoro-deoxyglucose uptake on PET-CT in hepatocellular adenoma. A mini review with a new case Report

RESUMEN La captación de 18 FDG en PET-TC por un adenoma hepatocelular (HCA) es poco frecuente. Esta situación genera dudas en cuanto a los diagnósticos diferenciales y tratamiento. El objetivo de este artículo fue realizar una mini revisión de los últimos 37 años de HCA con avidez por el 18FDG y presentar un nuevo caso. Sobre la base de un estudio realizado por otros autores entre 1984 y 2014, se amplía la búsqueda utilizando las mismas palabras clave hasta el año 2021. Se analizan los datos relevantes. Entre 1984 y 2021 detectamos 38 casos en 37 años. Fue más frecuente en mujeres en edad reproductiva. Los subtipos H-HCA e I-HCA fueron los más frecuentes. El tratamiento quirúrgico fue el más empleado. La diferenciación celular y los trastornos metabólicos de la glucosa y de los lípidos favorecerían la captación de 18FDG. La resección hepática ofrecería mayores garantías permitiendo el estudio completo de la lesión.

ABSTRACT Hepatocellular adenoma (HCA) uptake of 18FDG uptake on PET-CT is rare. This situation poses doubts about the differential diagnoses and treatment. The aim of this article is to perform a mini review of 18FDG avid HCA over the past 37 years and to describe a new case presentation. Based on a study conducted by other authors between 1984 and 2014, we extended the search until 2021 using the same keywords. The relevant data were analyzed. Between 1984 and 2021 we detected 38 cases in 37 years. HCAs were more common in women of childbearing age. The most common types were H-HCA an I-HCA. Surgical resection was the treatment most used. Cell differentiation and glucose and lipid metabolic diseases would favor 18FDG uptake. Liver resection provides better outcomes, allowing for a complete examination of the lesion.

Bleeding hepatocellular adenoma: historical series and outcomes / Adenoma hepatocelular sangrante: série histórica e desfechos

ABSTRACT Introduction: hepatocellular adenoma - AHC - is a rare benign neoplasm of the liver more prevalent in women at reproductive age and its main complication is hemorrhage. In the literature, case series addressing this complication are limited. Methods: between 2010 and 2022, 12 cases of bleeding AHC were attended in a high-complexity university hospital in southern Brazil, whose medical records were retrospectively evaluated. Results: all patients were female, with a mean age of 32 years and a BMI of 33kg/m2. The use of oral contraceptives was identified in half of the sample and also half of the patients had a single lesion. The mean diameter of the largest lesion was 9.60cm and the largest lesion was responsible for bleeding in all cases. The presence of hemoperitoneum was documented in 33% of the patients and their age was significantly higher than the patients who did not have hemoperitoneum - 38 vs 30 years, respectively. Surgical resection of the bleeding lesion was performed in 50% of the patients and the median number of days between bleeding and resection was 27 days. In only one case, embolization was used. The relation between ingrowth of the lesions and the time, in months, was not obtained in this study. Conclusion: it is concluded that the bleeding AHC of the present series shows epidemiological agreement with the literature and may suggest that older patients trend to have hemoperitoneum more frequently, a fact that should be investigated in further studies.

RESUMO Introdução: o Adenoma Hepatocelular - AHC - é uma neoplasia benigna rara do fígado associada a mulheres com idade reprodutiva. Sua principal complicação é o sangramento,mas as séries de casos direcionadas a esta intercorrência são limitadas. Métodos: entre os anos de 2010 e 2022 foram registrados 12 casos de AHC sangrante em um hospital universitário de alta complexidade no sul do Brasil, cujos prontuários foram retrospectivamente avaliados. Resultados: todos os pacientes eram do sexo feminino, com média de idade de 32 anos e de IMC de 33kg/m2. O uso de anticoncepcionais foi identificado em metade da amostra e também metade das pacientes apresentava lesão única. O diâmetro médio da maior lesão foi de 9,60cm e a maior lesão foi responsável pelo sangramento em todos os casos. Hemoperitôneo foi documentado em 33% das pacientes e a idade destas foi significativamente maior do que as pacientes que não apresentaram hemoperitôneo - 38 vs 30 anos, respectivamente. A ressecção cirúrgica da lesão sangrante foi realizada em 50% das pacientes e a mediana de dias entre o sangramento e a ressecção foi de 27 dias. Em apenas um caso foi lançado mão da embolização da lesão. Não se demonstrou correlação entre a taxa de redução das lesões e o passar dos meses, nos casos em que foi adotado tratamento conservador. Conclusão: conclui-se que aos AHC sangrantes da presente série apresentam concordância epidemiológica com a literatura e pode sugerir que as pacientes com maior idade tendem a apresentar hemoperitôneo mais frequentemente, fato que deve ser investigado em maiores estudos.

Hematoma subcapsular del hígado: morfología y resultados del tratamiento quirúrgico / Hepatic subcapsular hematoma: morphology and results of surgical treatment

RESUMEN: El hematoma subcapsular del hígado (HSH), es una entidad poco frecuente. La mayoría de casos reportados se asocian al embarazo, en el contexto de síndrome de recuento bajo de plaquetas, elevación de enzimas hepáticas, y hemólisis. Otras patologías relacionadas son ruptura de carcinoma hepatocelular, adenoma, hiperplasia nodular focal; y amilosis. El objetivo de este artículo fue reportar morfología y resultados del tratamiento quirúrgico observados en una serie de pacientes con HSH, en términos de morbilidad postoperatoria (MPO). Serie de casos retrospectiva de pacientes con HSH intervenidos de forma consecutiva en Clínica RedSalud Mayor Temuco, entre 2004 y 2019. La variable resultado fue MPO. Otras variables de interés fueron edad, sexo, etiología, diámetro, necesidad de transfusión y tiempo de hospitalización. Se utilizó estadística descriptiva. Se trató a 7 pacientes (71,4 % mujeres), con una mediana de edad de 46 años. La mediana del diámetro del HSH, tiempo quirúrgico y estancia hospitalaria fueron 11 cm, 105 min y 5 días, respectivamente. No hubo necesidad de reintervenciones. Con una mediana de seguimiento de 31 meses, no se verificó MPO ni mortalidad. El HSH es una condición poco frecuente, y la evidencia disponible escasa. Puede asociarse a condiciones benignas y malignas. Requiere un alto índice de sospecha para un diagnóstico oportuno.Su pronóstico depende de la etiología.

SUMMARY: Subcapsular hematoma of the liver (SHL) is a rare entity. The majority of cases are associated with pregnancy, in the context of low platelet count syndrome, elevated liver enzymes, and hemolysis. Other related pathologies are ruptured hepatocellular carcinoma, adenoma, focal nodular hyperplasia, and amyloidosis. The aim of this article was to report morphology and results of the surgical treatment observed in a series of patients with SHL, in terms of postoperative morbidity (POM). Retrospective case series of patients with SHL who were intervened consecutively at Clínica RedSalud Mayor Temuco, between 2004 and 2019. The results variable was MPO. Other variables of interest were age, sex, etiology, diameter, need for transfusion, and length of hospitalization. Descriptive statistics were used; 7 patients (71.4% women) were treated with a median age of 46 years. The median diameter of SHL, surgical time, and hospital stay were 11 months, no POM and mortality were verified. SHL is a rare condition, and the available evidence is scarce. It can be associated with benign and malignant diseases. It requires a high index of suspicion for a timely diagnosis. Its prognosis depends on the etiology.

Diagnosis and differential diagnosis between focal nodular hyperplasia with inflammatory hepatocellular adenoma on MRI / 中华肝胆外科杂志

Objective To compare the MRI features of focal nodular hyperplasia (FNH) and inflammatory hepatocellular adenoma (Ⅰ-HCA),with an aim to improve the diagnostic accuracy in the two lesions.Methods Patients who underwent dynamic-enhanced MRI with histopathologically confirmed FNHs (21 patients with 21 tumors) and Ⅰ-HCAs (10 patients with 12 tumors) were included in this retrospective study.The clinical and the imaging features,including the T2-and T1-weighted,diffusion weighted images,and the dynamic enhanced imagings were analyzed.Results No significant difference was observed in the clinical data between the 2 groups of patients,except in the serum levels of C-reactive protein.The serum C-reactive protein levels were significantly elevated in Ⅰ-HCA than in FNH.Significant differences between patients with FNHs and Ⅰ-HCAs were also found in the morphologic findings and the signal intensities (including shape,centre scar,necrosis,signal intensity of T2WI and DWI,and lesion signal intensity compared to those of the liver in the portal venous phase and delayed phase).The differences in lesion to liver signal in FNH were significantly lower than those in Ⅰ-HCA in the T2WI and the delayed phases.The area under the curve (AUC) for the 2 groups of patients were 0.843 and 0.743,respectively,with no significant difference between them.Conclusions The MRI appearances of atypical FNHs overlapped with Ⅰ-HCA.MRI features of isointensity on T2 Wl and DWI,and isointensity to the liver in the delayed phase were valuable to differentiate FNHs from Ⅰ-HCAs.Most Ⅰ-HCAs showed moderate and marked high signal intensity on T2WI and DWI.These features,when combined with an elevated serum C-reaction protein,necrosis in the lesion and hyperintensity in the delayed phase,were valuable in differentiating Ⅰ-HCAs from FNH.

The value of CT and MRI in the diagnosis of hepatocellular adenoma / 实用放射学杂志

Objective To study the value of CT and MRI in the diagnosis of hepatocellular adenoma(HCA).Methods The comprehensive imaging features of HCA in 11 patients confirmed by pathology were analyzed retrospectively in our hospital.Results 11 patients presented with a total of 18 lesions, and plain CT showed low or slightly low density in all lesions, with irregular high density area in two lesions.The CT values of the lesions were significantly higher than in adjacent normal liver in the arterial phases(P<0.05).On T1WI, two lesions showed low or slightly low signal intensity, and 16 lesions showed slight hyperintensity.On T2WI, 14 lesions showed hyperintensity, and 4 lesions showed hypointensity.All lesions showed significant enhancement in arterial phase of dynamic enhanced scanning.Pseudocapsule enhancement was revealed in 17 lesions.For 18 lesions, ADC values were measured on DWI, and the ADC values of the lesions were higher than the value of surrounding normal liver parenchyma.Conclusion Dynamic contrast-enhanced CT combined with MRI and ADC value measurement can provide valuable information in diagnosis of HCA.

Benign hepatocellular nodules of healthy liver: focal nodular hyperplasia and hepatocellular adenoma

Owing to the progress of imaging techniques, benign hepatocellular nodules are increasingly discovered in the clinical practice. This group of lesions mostly arises in the context of a putatively normal healthy liver and includes either pseudotumoral and tumoral nodules. Focal nodular hyperplasia and hepatocellular adenoma are prototypical examples of these two categories of nodules. In this review we aim to report the main pathological criteria of differential diagnosis between focal nodular hyperplasia and hepatocellular adenoma, which mainly rests upon morphological and phenotypical features. We also emphasize that for a correct diagnosis the clinical context such as sex, age, assumption of oral contraceptives, associated metabolic or vascular disturbances is of paramount importance. While focal nodular hyperplasia is a single entity epidemiologically more frequent than adenoma, the latter is representative of a more heterogeneous group which has been recently and extensively characterized from a clinical, morphological, phenotypical and molecular profile. The use of the liver biopsy in addition to imaging and the clinical context are important diagnostic tools of these lesions. In this review we will survey their systematic pathobiology and propose a diagnostic algorithm helpful to increase the diagnostic accuracy of not dedicated liver pathologists. The differential diagnosis between so-called typical and atypical adenoma and well differentiated hepatocellular carcinoma will also be discussed.

Benign hepatocellular nodules of healthy liver: focal nodular hyperplasia and hepatocellular adenoma

Owing to the progress of imaging techniques, benign hepatocellular nodules are increasingly discovered in the clinical practice. This group of lesions mostly arises in the context of a putatively normal healthy liver and includes either pseudotumoral and tumoral nodules. Focal nodular hyperplasia and hepatocellular adenoma are prototypical examples of these two categories of nodules. In this review we aim to report the main pathological criteria of differential diagnosis between focal nodular hyperplasia and hepatocellular adenoma, which mainly rests upon morphological and phenotypical features. We also emphasize that for a correct diagnosis the clinical context such as sex, age, assumption of oral contraceptives, associated metabolic or vascular disturbances is of paramount importance. While focal nodular hyperplasia is a single entity epidemiologically more frequent than adenoma, the latter is representative of a more heterogeneous group which has been recently and extensively characterized from a clinical, morphological, phenotypical and molecular profile. The use of the liver biopsy in addition to imaging and the clinical context are important diagnostic tools of these lesions. In this review we will survey their systematic pathobiology and propose a diagnostic algorithm helpful to increase the diagnostic accuracy of not dedicated liver pathologists. The differential diagnosis between so-called typical and atypical adenoma and well differentiated hepatocellular carcinoma will also be discussed.

C3H/He Mice as an Incompatible Cholangiocarcinoma Model by Clonorchis sinensis, Dicyclanil and N-Nitrosodimethylamine

Clonorchis sinensis is a Group-I bio-carcinogen, associated with cholangiocarcinoma (CCA). The hamster is the only experimental model of C. sinensis-mediated CCA, but we oblige another animal model. The present study intended to develop a C. sinensis (Cs) mediated CCA model using C3H/He mice, co-stimulated with N-nitrosodimethyl-amine (NDMA) and dicyclanil (DC). The mice were divided into 8 groups with different combinations of Cs, NDMA, and DC. Six months later the mice were sacrificed and subjected to gross and histopathological examination. The body weights were significantly reduced among the groups treated with 2 or more agents (eg. Cs+NDMA, Cs+DC, NDMA+DC, and Cs+NDMA+DC). In contrast, liver weight percentages to body weight were increased in above groups by 4.1% to 4.7%. A Change of the spleen weight was observed only in Cs+NDMA group. Though C. sinensis infection is evident from hyperplastic changes, only 1 worm was recovered. T wo mice, 1 from Cs and the other from Cs+DC group, showed mass forming lesions; 1 (281.2 mm3) from the Cs group was a hepatocellular adenoma and the other (280.6 mm3) from the Cs+DC group was a cystic mass (peliosis). Higher prevalence of gray-white nodules was observed in Cs group (42.9%) followed by Cs+NDMA+DC group (21.4%). The mice of the Cs+NDMA+DC group showed hyper-proliferation of the bile duct with fibrotic changes. No characteristic change for CCA was recognized in any of the groups. In conclusion, C3H/He mice produce no CCA but extensive fibrosis when they are challenged by Cs, NDMA, and DC together.

Diagnosis and treatment of benign liver nodules: Brazilian Society of Hepatology (SBH) recommendations

ABSTRACT Space-occupying lessions of the liver may be cystic or solid. Ultrasonography is an extremely useful method for initial screening, and suffices for diagnosis of simple hepatic cysts. Complex cysts and solid masses require computed tomography or magnetic resonance imaging for confirmation. Wide surgical excision is indicated in cystadenoma or cystadenocarcinoma. Clinical and epidemiological data are important, as nodules in noncirrhotic livers are more likely to be benign. Hemangiomas, the most common benign tumors, require no follow-up after diagnostic confirmation if they are small and asymptomatic. Patients with giant, symptomatic hemangiomas or compression of adjacent structures should be referred to hepatobiliary centers for potential surgery. The genetic heterogeneity of hepatocellular adenoms and their epidemiology and prognosis prompted classification of these tumors into four subtypes based on histology and immunohistochemistry. The major complications of hepatocellular adenoms are rupture with bleeding and malignant transformation. Rupture occurs in approximately 30% of cases. The main risk factors are tumors size >5 cm and inflammatory subtype. Hepatocellular adenoms may enlarge during pregnancy due to marked hormonal stimulation. As oral contraceptive pills and anabolic steroids have associated with hepatocellular adenoms growth, particularly of the hepatocyte nuclear factor-1 alfa subtype, these drugs should be discontinued. Focal nodular hyperplasia is the second most common benign tumor of hte liver. It is most frequent in women aged 20 to 60, and 70% to 90% of cases are asymptomatic. In the adsence of a central scar and/or other hallmarks of Focal nodular hyperplasia, with uncertainty between this diagnosis and hepatocellular adenoma, liver-specific contrast agentes are indicated.

RESUMO As lesões que ocupam espaço no fígado podem ser císticas ou sólidas. A ultrassonografia é extremamente útil como rastreamento inicial, bastando como método diagnósticos em casos de cistos simples. Em cistos complexos e em nódulos sólidos é necessária a complementação diagnóstica com tomografia computadorizada ou ressonância magnética. Em casos de cistadenoma ou cistadenocarcinoma, a ampla retirada cirúrgica está indicada. Dados clínico-epidemiológicos são importantes, já que nódulos em fígados não-cirróticos têm maiores probabilidades de serem benignos. Para os hemangiomas, tumores benignos mais frequentes, após a confirmação diagnóstica não existe necessidade de acompanhamento sistemático quando os nódulos são pequenos e assintomáticos. Hemangiomas gigantes sintomáticos ou comprimindo órgãos vizinhos devem ser encaminhados a centros de referência para avaliação de intervenção cirúrgica. A heterogeneidade genética nos adenomas hepatocelulares bem como características epidemiológicas e prognósticas motivou sua classificação em quatro subtipos, com base em achados histológicos e de imunohistoquímica. As principais complicações que ocorrem com o adenomas hepatocelulares são ruptura com hemorragia e transformação carcinomatosa. A primeira ocorre em cerca de 30% dos casos e o principal fator de risco para esta complicação são tumores maiores do que 5 cm, do subtipo hiperplasia nodular focal 1A, esses medicamentos devem ser suspensos. A hiperplasia nodular focal é o segundo tumor benigno mais frequente, mais comum nas mulheres entre 20 e 60 anos, sendo assintomáticos em 70% a 90% dos casos. Na ausência de lesão cicatricial central e/ou outros sinais sugestivos de hiperplasi nodular focal, havendo dúvida diagnóstica com adenoma hepatocelular, o uso de contraste hepatespecíficos está indicado.

Adenomas hepatocelulares: hallazgos actuales en imágenes que permiten su caracterización y manejo / Hepatocellular Adenomas: Current Findings in Images Which Allow its Characterization and Management

Objetivos: El enfoque terapéutico de los adenomas ha cambiado en los últimos años, en especial por las posibilidades de caracterización por medio de las imágenes diagnósticas, principalmente la resonancia magnética (RM), que en la mayoría de los casos ha permitido una aproximación al tipo de adenoma. Métodos: Se realizó una revisión de la literatura reciente con el fin de describir las características imagenológicas de los tipos de adenomas, en las diferentes técnicas de imágenes, con principal énfasis en los hallazgos imagenológicos en resonancia magnética, lo cual permite diferenciar entre los subtipos histológicos de adenomas y ayuda a orientar el manejo médico o quirúrgico. Resultados: En la literatura se describe la adenomatosis hepática como una entidad frecuente en mujeres, de características imagenológicas atípicas. Además, se mencionan las características de los hallazgos por RM y su correlación con los tipos de adenomas, variedad esteatósica, peliótica y mixta. Conclusión: De acuerdo con la clasificación basada en las características genéticas, histopatológicas e imagenológicas de los diferentes subtipos de AHC y según la sintomatología, se podría determinar la historia natural y definir el pronóstico y las opciones terapéuticas o de seguimiento imagenológico.

Objective: The therapeutic approach of adenomas has changed in recent years, especially because of the possibilities for characterization by means of diagnostic imaging methods, mainly magnetic resonance imaging, which allowed us, in most cases, to approach the type of adenoma. Methods: A review of the recent literature was conducted in order to describe the characteristic imaging features of the types of adenomas in the different imaging techniques, with an emphasis on MRI, which allows differentiation between histologic subtypes of adenomas. In addition, it also helps guide medical or surgical management. Results: In the literature, we described hepatic adenomatosis as an entity which is frequently found in women, with atypical imaging features. In addition, we mentioned the characteristics of MRI findings and their correlation with the types of adenomas, inflammatory, steatosic, ß-catenin mutated and mixed. Conclusion: According to the classification based on genetic, histopathological and imaging features of the different subtypes of AHC, we could determine the natural history, define prognosis and the therapeutic options or imaging follow-up.

Hepatocellular Adenoma and Focal Nodular Hyperplasia / 대한내과학회지

Recent advances in imaging technologies have offered us a great chance to detect a variety of focal liver lesions. Accordingly, it is of paramount importance to determine whether these focal liver lesions are malignant or nonmalignant. Some benign hepatic tumors mimicking hepatocellular carcinoma typically develop from either regenerative or dysplastic/neoplastic processes. The most common benign hepatic solid tumors that are not of vascular origin include focal nodular hyperplasia and hepatocellular adenoma. A majority of patients with benign hepatic tumors are often asymptomatic and require no specific treatment. However, surgical resection may be infrequently needed for cases with clinical symptoms or malignant potential. This review will touch on the epidemiology, pathogenesis, clinical features, diagnosis, and management of focal nodular hyperplasia and hepatocellular adenoma.

beta-catenin activated hepatocellular adenoma

No abstract available.

Hepatocellular adenoma and liver adenomatosis: a report of 11 patients / 中华肝胆外科杂志

Objective To review the clinical features,therapeutic approach and prognosis of hepatocellular adenoma(HCA)and liver adenomatosis(LA).Methods The clinical data from patients with histopathological diagnosis confirmed on operative specimens were analyzed retrospectively.Results There were 10 patients with HCA and 1 with LA.The disease was found mainly in females (n=7,63.6％),and only one female patient with LA had a history of use of oral contraceptive.The median age at presentation was 33 years(range,25-70 years).Most patients(n=8,72.7％)had no significant symptom.Tumor markers including CA19-9 and alpha fetoprotein(AFP)were normal.On dynamic ultrasonography,CT and MRI,most lesions showed contrast enhancement in the arterial phase and washout in the portal venous phase and delayed phase.For the 10 patients with HCA,the lesion was solitary.On histopathology,atypia and dysplasia were present in 1 patient,dysplasia in 1 patient,and active tumor cell growth in 1 patient.The patients with liver adenomatosis had multiple lesions and atypia.All patients underwent liver resection.There was no recurrence on follow-up which ranged from 21 to 125 months.Conclusions Most patients had no clinical symptoms.Hepatic steato sis may be a potential cause for HCA and LA.Oral contraceptive plays an important role in the patho genesis of LA.Dynamic imaging examinations were helpful for diagnosis.In view of the associated risks of hemorrhage and malignant transformation,surgical resection is the optimal treatment.The prognosis is good.

An Intraluminal Gallbladder and Bile Duct Hematoma after a Percutaneous Biopsy of Hepatic Adenoma / 대한내과학회지

Hepatocellular adenoma is a rare, but benign, tumor mostly found in women taking oral contraceptives. Hepatocellular adenoma must be treated when bleeding of the tumor, intraperitoneal hemorrhage, or malignant transformation occurs. A percutaneous liver biopsy is relatively safe and effective, but carries the risk of mild complications, such as pain, temporary hypotension, and bleeding, and severe complications, such as intraperitoneal bleeding, peritonitis, pneumothorax, hemothorax, other organ injury, and sepsis. We treated a 33-year-old woman with hemobilia and gallbladder hematoma following a sono-guided percutaneous liver biopsy. Complete quadrantectomy with anterior lobe resection was done after angiography and embolization of the hepatic artery.

Diagnosis and treatment of hepatocellular adenoma / 中华消化外科杂志

Objective To study the diagnosis and treatment of hepatocellular adenoma(HCA).Methods The preoperative imaging findings,pathologic specimens and surgical treatment of 18 patients with HCA who were admitted in our hospital from January 1990 to April 2007 were retrospectively analyzed.Results Most patients were male(male-to-female:11/7)and only 1 female patient had oral contraceptive history.Six patients presented with pain in the right upper quadrant.Contrast-enhanced CT and contrast-enhanced MRI both displayed that most lesions were characterized by homogeneous enhancement on arterial phase,except the lesions affected by irregular hemorrhage or fatty degeneration,and by washout on portal venous phase and delayed phase.All patients received resection.Hemorrhage in the lession was found in 10 patients and precancerous lesion in 2after operation.All patients were alive and well with no recurrence till December 2007.Conclusion The enhanced CT or MRI scanning for HCA has special features.Complete resection is the first choice for HCA.

Clinical analysis of hepatocellular adenoma:a report of 10 cases / 中国综合临床

Objective To study the clinical feature,diagnosis,treatment and prognosis of hepatocellular adenoma(HA).Methods The clinical data of 10 patients confirmed pathologically with HA,were retrospectively analyzed.Results There were four females and six males,aging from 25 to 71 years(mean:42.6 years).Among these 10 patients,6 cases were discovered to have no clinical symptom.Tumors were located in the right lobe of the liver in 4 cases,and in the left lobe in 6 cases.Uhrasonography was performed in all cases.Six cases underwent CT examination and three cases experienced MRI as well as angiography was conducted in one case.All cases were confirmed by complete excision and pathology.All of them were followed up for 5 months to 9 years without tumor recurrence.Conclusion The combination of imaging data is helpful in the diagnosis of HA.Surgery is the best treatment with satisfactory results,and its prognosis is fairly good.

Hepatocellular adenoma in a Eurasian otter (Lutra lutra)

A 7-year-old female Eurasian otter (Lutra lutra) at the Seoul Grand Park, Korea, died after displaying depression, anorexia, weight loss and rough skin for several days. At necropsy, a solitary friable round mass, which was approximately 12 x 9 x 5 cm and mottled dark red and yellow, was found bulging from the right hepatic lobe. Microscopically, the nonencapsulated, poorly circumscribed mass was composed of solid sheets of neoplastic hepatocytes. In addition, numerous small tan foci, ranging from 0.5 to 1.0 cm in diameter, were evenly scattered throughout the pancreatic tissue. These foci were found to be nonencapsulated, well-demarcated hyperplastic nodules of the exocrine pancreatic gland. We observed neither intrahepatic nor extrahepatic metastases. Based on the gross and microscopic changes, we diagnosed the animal as having a hepatocellular adenoma accompanied by exocrine pancreatic nodular hyperplasia.

Hepatocellular Carcinoma Arising in Hepatocellular Adenoma / 대한간학회지

No abstract available.