Dokmak Safi, Cauchy Francois, Belghiti Jacques
Department of Hepatobiliary Surgery and Liver Transplantation Beaujon Hospital, AP-HP, University Paris-Diderot, Clichy, France.
Expert Rev Gastroenterol Hepatol. 2014 Sep;8(7):803-10. doi: 10.1586/17474124.2014.917957. Epub 2014 Jun 24.
Hepatocellular adenoma (HCA) is a rare benign liver-cell neoplasm, occurring predominantly in young obese women using oral contraceptives. HCA is a heterogeneous disease, which includes four subtypes (including unclassified) associated with various risks of haemorrhagic complications and malignant transformation. Magnetic resonance imaging is the modality of choice for both diagnosis and subtype characterization of HCA whereas percutaneous biopsy has only limited impact on the therapeutic strategy. In men HCA should be always resected while in women surgery should only be considered for lesions ≥5 cm and after cessation of hormonal therapy. Women with single or multiple HCAs <5 cm may be followed with regular MRI imaging since the vast majority of HCA remains stable or decreases in size. Pregnancy should not be discouraged provided close sonographic surveillance is undertaken.
肝细胞腺瘤（HCA）是一种罕见的良性肝细胞肿瘤，主要发生在使用口服避孕药的年轻肥胖女性中。HCA是一种异质性疾病，包括四种亚型（包括未分类亚型），与各种出血并发症和恶性转化风险相关。磁共振成像（MRI）是HCA诊断和亚型特征描述的首选方式，而经皮活检对治疗策略的影响有限。男性的HCA应始终进行切除，而女性仅对直径≥5 cm的病变以及在激素治疗停止后才考虑手术。患有单个或多个直径<5 cm的HCA的女性可通过定期MRI成像进行随访，因为绝大多数HCA保持稳定或体积缩小。只要进行密切的超声监测，就不应阻止怀孕。
