Hepatic Adenomatosis in a Young Asymptomatic but High-risk Patient: An Incidental Diagnosis with Potentially Severe Clinical Implications
  • Davide Lanza
    Department of Gastroenterology and Hepatology, Regional Hospital Oberaargau, Langenthal, Switzerland
  • Mentor Bilali
    Department of Gastroenterology and Hepatology, Regional Hospital Oberaargau, Langenthal, Switzerland

Keywords

Hepatic adenomatosis, hepatic adenoma, focal nodular hyperplasia, steatosis hepatis

Abstract

Hepatic adenomatosis (HA) is a very rare condition and defined as the presence of 10 or more adenomas in an otherwise normal liver. HA has an incidence of 10–24% in patient with hepatic adenoma and it is more common in women. Most patients with HA are asymptomatic with a normal liver function test and half of cases are detected incidentally on imaging. Although HA is considered a benign disease, some patients may develop potentially fatal complications, such as hypovolaemic shock due to rupture of the liver lesion or malignant transformation to hepatocellular carcinoma.
We report the case of a 29-year-old woman who presented to the emergency room after a car accident. Whole-body computed tomography revealed multiple focal hepatic hypervascular lesions in the right lobe of the liver together with a fatty liver. Subsequent hepatic magnetic resonance imaging suggested the diagnosis of HA with a suspicion of focal nodular hyperplasia (FNH). The patient refused to undergo liver biopsy, so we instituted a 3-month surveillance program, which included clinical assessment, liver function tests, tumour marker assessment and blood tests as well as sonographic evaluation for follow-up of the liver lesions.

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References

  • Flejou JF, Barge J, Menu Y, Degott C, Bismuth H, Potet F, et al. Liver adenomatosis. An entity distinct from liver adenoma? Gastroenterology 1985;89(5):1132–1138.
  • Barthelmes L, Tait I. Liver cell adenoma and liver cell adenomatosis. HPB (Oxford) 2005;7(3):186–196.
  • Chiche L, Dao T, Salamé E, Galais MP, Bouvard N, Schmutz G, et al. Liver adenomatosis: reappraisal, diagnosis, and surgical management: eight new cases and review of the literature. Ann Surg 2000;231(1):74–81.
  • Agrawal S, Agarwal S, Arnason T, Saini S, Belghiti J. Management of hepatocellular adenoma: recent advances. Clin Gastroenterol Hepatol 2015;13(7):1221.
  • Gonçalves DL, Leite JP, Silva R, Pissarra AP, Caetano Oliveira R, Silva D. Hepatic adenomatosis: a challenging liver disease. GE Port J Gastroenterol 2020;27:37–42.
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    Published: 2021-11-04
    Issue: 2021: Vol 8 No 11 (view)


    How to cite:
    1.
    Lanza D, Bilali M. Hepatic Adenomatosis in a Young Asymptomatic but High-risk Patient: An Incidental Diagnosis with Potentially Severe Clinical Implications. EJCRIM 2021;8 doi:10.12890/2021_002999.