Management of hepatocellular adenoma: Comparison of resection, embolization and observation Journal Article

Authors: Karkar, A. M.; Tang, L. H.; Kashikar, N. D.; Gonen, M.; Solomon, S. B.; DeMatteo, R. P.; D'Angelica, M. I.; Correa-Gallego, C.; Jarnagin, W. R.; Fong, Y.; Getrajdman, G. I.; Allen, P.; Kingham, T. P.
Article Title: Management of hepatocellular adenoma: Comparison of resection, embolization and observation
Abstract: Introduction: Hepatocellular adenoma (HA) is an uncommon benign hepatic tumour with the potential for malignant change or spontaneous haemorrhage. Resection has been the recommended treatment, but outcomes with other approaches are ill defined. Methods: Demographic and outcomes data were retrospectively collected on patients diagnosed with HA at a tertiary hepatobiliary centre from 1992-2011 whom underwent resection, bland embolization or observation. Results: In total, 52 patients with 100 adenomas were divided into single HA (n = 27), multiple HA (n = 18), and adenomatosis (n = 7) groups. Eighty-seven per cent were female and 37% had a history of hormone use. Median sizes of resected, embolized and observed adenomas were 3.6 cm, 2.6 cm and 1.2 cm, respectively. Forty-eight adenomas were resected as a result of suspicion of malignancy (39%) or large size (39%); 61% of these were solitary. Thirty-seven were embolized for suspicion of malignancy (56%) or hsemorrhage (20%); 92% of these were multifocal. Two out of three resected adenomas with malignancy were ≥10 cm and recurred locally [4%, confidence interval (CI) 1-14%]. Ninety-two per cent of the embolized adenomas were effectively treated; three persisted (8.1%, CI 2-22%). Most observed lesions did not change over time. Conclusions While solitary adenomas are often resected, multifocal HAs are frequently embolized. Small adenomas can safely be observed. Given low recurrence rates, select HAs can be considered for embolization. © 2012 International Hepato-Pancreato-Biliary Association.
Journal Title: HPB
Volume: 15
Issue: 3
ISSN: 1365-182X
Publisher: Elsevier Science, Inc.  
Date Published: 2013-03-01
Start Page: 235
End Page: 243
Language: English
DOI: 10.1111/j.1477-2574.2012.00584.x
PROVIDER: scopus
PMCID: PMC3572286
PUBMED: 23374365
Notes: --- - "Export Date: 1 March 2013" - "CODEN: HPBIF" - "Source: Scopus"
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MSK Authors
  1. Ronald P DeMatteo
    605 DeMatteo
  2. Mithat Gonen
    721 Gonen
  3. Peter Allen
    445 Allen
  4. William R Jarnagin
    598 Jarnagin
  5. Yuman Fong
    746 Fong
  6. T Peter Kingham
    295 Kingham
  7. Stephen Solomon
    270 Solomon
  8. Laura Hong Tang
    331 Tang
  9. Juan Camilo Correa
    24 Correa
  10. Ami Karkar
    6 Karkar