Case-orientated approach to the management of hepatocellular adenoma

D. J. Van Der Windt, N. F.M. Kok, Shahid Hussain, P. E. Zondervan, I. P.J. Alwayn, R. A. De Man, J. N.M. Ijzermans

Research output: Contribution to journalArticle

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Abstract

Background: Treatment of suspected hepatocellular adenoma (HA) remains controversial. The aim of this study was to evaluate the management of HA at a time when magnetic resonance imaging (MRI) and computed tomography (CT) are highly sensitive methods for diagnosing HA. Methods: Between January 2000 and January 2005, data from 48 consecutive women with HA (median age 36 years) were prospectively collected. The protocol for diagnostic work-up consisted of multiphasic MRI or CT. Management was observation if the tumour was smaller than 5 cm and surgical intervention if it was 5 cm or larger. Results: The median follow-up was 24 (range 3-73) months. Sixteen (33 per cent) patients had invasive procedures because of tumour size 5 cm or larger, malignant characteristics or haemorrhage. The remaining 32 patients (67 per cent) were observed; haemorrhage and malignant degeneration did not occur and none of the lesions showed enlargement after withdrawal of oral contraceptives. Multiple HAs were found in 32 (67 per cent) patients; liver steatosis was significantly more common in these patients than in those with a solitary lesion (59 versus 19 per cent; P = 0.008). Conclusion: Observation of adenomas smaller than 5 cm is justified because of improved radiological reliability. Resection should be reserved for patients with malignant tumour characteristics or with single lesions 5 cm or larger.

Original languageEnglish (US)
Pages (from-to)1495-1502
Number of pages8
JournalBritish Journal of Surgery
Volume93
Issue number12
DOIs
StatePublished - Dec 1 2006

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Liver Cell Adenoma
Tomography
Magnetic Resonance Imaging
Observation
Hemorrhage
Neoplasms
Fatty Liver
Oral Contraceptives
Adenoma

ASJC Scopus subject areas

  • Surgery

Cite this

Van Der Windt, D. J., Kok, N. F. M., Hussain, S., Zondervan, P. E., Alwayn, I. P. J., De Man, R. A., & Ijzermans, J. N. M. (2006). Case-orientated approach to the management of hepatocellular adenoma. British Journal of Surgery, 93(12), 1495-1502. https://doi.org/10.1002/bjs.5511

Case-orientated approach to the management of hepatocellular adenoma. / Van Der Windt, D. J.; Kok, N. F.M.; Hussain, Shahid; Zondervan, P. E.; Alwayn, I. P.J.; De Man, R. A.; Ijzermans, J. N.M.

In: British Journal of Surgery, Vol. 93, No. 12, 01.12.2006, p. 1495-1502.

Research output: Contribution to journalArticle

Van Der Windt, DJ, Kok, NFM, Hussain, S, Zondervan, PE, Alwayn, IPJ, De Man, RA & Ijzermans, JNM 2006, 'Case-orientated approach to the management of hepatocellular adenoma', British Journal of Surgery, vol. 93, no. 12, pp. 1495-1502. https://doi.org/10.1002/bjs.5511
Van Der Windt DJ, Kok NFM, Hussain S, Zondervan PE, Alwayn IPJ, De Man RA et al. Case-orientated approach to the management of hepatocellular adenoma. British Journal of Surgery. 2006 Dec 1;93(12):1495-1502. https://doi.org/10.1002/bjs.5511
Van Der Windt, D. J. ; Kok, N. F.M. ; Hussain, Shahid ; Zondervan, P. E. ; Alwayn, I. P.J. ; De Man, R. A. ; Ijzermans, J. N.M. / Case-orientated approach to the management of hepatocellular adenoma. In: British Journal of Surgery. 2006 ; Vol. 93, No. 12. pp. 1495-1502.
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