Sornmayura Pattana, Siripornpitak Suvipaporn, Leela-udomlipi Surasak, Bunyaratvej Sukhum
Department of Pathology Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2010 Mar;93(3):393-7.
A case of hepatocellular adenoma (HCA) was described in a 26-year-old woman, who was a potential kidney donor for her father and denied taking the oral contraceptive pill. A hypervascular mass of 4.1 cm in largest dimension was detected in the liver segment V by computerized tomography and magnetic resonance imaging (MRI). The normal levels of liver enzymes, negative serum markers for hepatitis viruses, and non-elevated alpha- fetoprotein level were detected. The wedge resection of segment V was done with an uneventful clinical course. In Western countries, HCAs are known to occur in women in their reproductive periods. It may not be associated with oral contraceptive. Molecular biological studies disclosed three variants of HCAs, i.e., I) with mutation of HNF 1-alpha gene, II) with mutation of beta-catenin gene, and III) no mutation of the two genes. Histological correlations with the three variants as recommended by the Bordeaux group in 2007 could not be accomplished in the present study due to overlapping histological features between the variants I and III. The etiological factors of HCA are known to relate to the contraceptive pill usage in female and the anabolic-androgenic-steroid administration in male. In Thailand, the occurrence of HCA is expected to be only 0.3% of cases with hepatocellular carcinoma.
一名26岁女性被诊断为肝细胞腺瘤（HCA）。该女性是其父亲潜在的肾脏供体，否认服用口服避孕药。通过计算机断层扫描和磁共振成像（MRI）在肝V段发现一个最大直径为4.1 cm的高血管性肿块。检测到肝酶水平正常、肝炎病毒血清标志物阴性且甲胎蛋白水平未升高。对V段进行了楔形切除术，临床过程顺利。在西方国家，已知HCA发生于育龄期女性，可能与口服避孕药无关。分子生物学研究揭示了HCA的三种变体，即：I）HNF 1-α基因突变型；II）β-连环蛋白基因突变型；III）这两个基因均无突变型。由于变体I和III之间的组织学特征重叠，本研究未能按照2007年波尔多小组的建议完成与这三种变体的组织学关联。已知HCA的病因与女性使用避孕药和男性使用合成代谢雄激素类固醇有关。在泰国，预计HCA的发生率仅为肝细胞癌病例的0.3%。
