| Disease | Hepatocellular adenomas (HA) are rare benign liver tumors, most frequently occurring in women using oral contraception. HA are single or more rarely multiple nodules; the presence of more than ten nodules in the liver indicates a specific nosological entity: liver adenomatosis |
| Etiology | In 90% of the cases, adenomas are sporadic and only rare cases are developed in a familial context: ( Familial liver adenomatosis). Patients with an inherited mutation in one allele of TCF1/HNF1a may develop maturity onset diabetes of the young type 3 (MODY3) and familial liver adenomatosis, when the second allele is inactivated in hepatocytes by somatic mutation or chromosome deletion. |
| Epidemiology | Hepatocellular adenomas are usually related to oral contraceptive use. The other risk factors are : glycogen storage diseases and the androgen therapy. HA are rare tumours: their estimated incidence in France is approximately one case per 100,000 women. Over the past fifteen years, their incidence has seen a sustained decline in industrialised countries; this trend is probably linked to the reduction in ethinylestradiol doses in oral contraceptives. |
| Pathology | These tumours result from a benign proliferation of hepatocytes which destroy the normal architecture of the liver. They are usually hyper-vascularised and typical adenoma corresponds to a proliferation of benign hepatocytes, intermingled with numerous thin-walled vessels, without portal tracts. |
| Treatment | Surgery is usually proposed for lesion of more than 3 cm |
| Evolution | Hepatocellular adenoma may bleed, or rarely, undergo malignant transformation. |
| Prognosis | The molecular and pathological classification of hepatocellular adenomas permits the identification of strong genotype-phenotype correlations and suggests that adenomas with beta-catenin activation have a higher risk of malignant transformation. |
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