What Are Hepatocellular Adenomas By Samantha Jespersen

The body recycles its old cells and replaces them with new cells.  However, if a mutation occurs in the DNA of the cells, the cells will grow abnormally.  Abnormal cells are known as precancerous cells, though the cells almost never turn cancerous. When a bunch of cells with a genetic mutation are found, it is known as a mass.  A mass can be benign (noncancerous) or malignant (cancerous). Benign tumors do not spread to other regions of the body and are typically removed with surgery.   Malignant tumors eventually spread once they have reached stages I, II, or III. They spread throughout the body and often require a combination of surgery, chemotherapy, or radiation. Adenomas are a type of benign tumor found on glandular organs.

Many times when oral contraceptives are used, they contain high doses of estrogen and progesterone.  There is a link between high doses of estrogen and adenomas. Often, hepatocellular adenomas are found in women between the ages of ten and fifty who are on birth control; however, there have been cases where hepatocellular adenomas have been found in men.

Very rarely do these masses cause problems, and therefore go unnoticed. Occasionally, an adenoma may grow to a large enough size that it causes pain by pushing against other organs.  This is when surgery is most likely to be suggested.  In most cases, adenomas are not found intentionally but are found when having a medical procedure such as a CT scan or an MRI to rule out other medical issues.  This is when a technician might find an unusual mass and send results to the doctor to look for more answers.

Usually, a doctor will perform several tests to figure out the cause of this mass in the body.  It may include blood work (including testing for tumor markers), biopsy (when a small piece of the tumor is removed and then looked at on slides and sent to pathology to determine if it is cancerous), or more CT scans or MRIs. This gives the doctors a better idea of what they are dealing with, more specifically the size and location of the tumor.

Because these masses can grow fairly large in size, a liver transplant may be considered in extreme situations.  Luckily, the liver is the only organ to regenerate or regrow.  This means a partial transplant would most likely occur and the donor would most often be a relative.  After a few years, both the patient and the donor will have whole livers again.

As with any tumor, there is a slight chance it may regrow, even after being removed.  For this reason, many doctors recommend stopping oral contraceptives or finding a new means of birth control.  Surgery only takes a handful of hours in the operating room under general anesthesia. After surgery, the adenoma is sent to pathology to confirm it is not malignant. The tumor may be located on the liver or in the liver.  If it is on the liver, the surgery is fairly simple.  If the tumor is in the liver, it is a bit more complicated.  The liver must be dissected to remove the mass, however, if the mass is near one of the main bile ducts, complications will most likely occur. The patient may spend a few days in the hospital afterward to make sure there are no complications from the surgery.  Pain medicines are prescribed and the patient will spend up to two months in recovery. If surgery is not conducted, there is a chance the adenoma may burst or rupture, causing blood to spill into the abdominal cavity.

 

References:

Cancer.gov http://www.cancer.gov/cancertopics/factsheet/detection/staging

Liverfoundation.org http://www.liverfoundation.org/abouttheliver/info/benigntumors/

Medlineplus.com http://www.nlm.nih.gov/medlineplus/benigntumors.html#cat45