Retrospective analysis of 29 patients surgically treated for hepatocellular adenoma or focal nodular hyperplasia

Background/Aims: Hepatocellular adenoma resection and focal nodular hyperpl asia supervision are widely recognized as the best management when these be nign liver tumors are diagnosed. Differential diagnosis is thus mandatory. Methodology: Twenty-nine patients with a presumed benign Liver tumor were r etrospectively analyzed. Results: Histopathological analysis of these resected liver tumors demonstr ated hepatocellular adenoma in 16 patients and focal nodular hyperplasia in 13. One hepatocellular carcinoma was disclosed into a hepatocellular adeno ma and 2 hepatocellular adenoma showed foci of liver-cell dysplasia. Seven patients with hepatocellular adenoma (43%) had evidence of intratumoral hem orrhage, among which 3 patients were admitted with intraperitoneal tumoral rupture. Computed tomography, performed in 26 patients, was the most reliab le examination to characterize these presumed benign liver tumors. Magnetic resonance imaging concerned only 5 patients but 3 hepatocellular adenoma a nd 1 focal nodular hyperplasia were diagnosed. The indications of focal nod ular hyperplasia surgical resection were chronic pain (4pts), hepatocellula r adenoma diagnosis (4pts), undeterminate Liver mass (2pts), a liver mass o f unknown origin in patients with a neoplastic history (3pts). A diagnosis of focal nodular hyperplasia assumed by the imaging work-up was always hist ologically confirmed. All the patients underwent hepatic resection with no mortality. Conclusions: This report underlines the risk of hemorrhage or malignant tra nsformation of hepatocellular adenoma that;justifies a safety surgical rese ction. An imaging work-up in favor of focal nodular hyperplasia allows radi ological observation.