Meyer Claire, Lisker-Melman Mauricio
Dr. Claire Meyer,
Dr. Mauricio Lisker-Melman,
Curr Hepatol Rep. 2015 Jun;14(2):139-143. doi: 10.1007/s11901-015-0265-7. Epub 2015 May 2.
Hepatic adenomatosis and hepatocellular adenomas share risk factors and the same pathophysiologic spectrum. The presence in the liver of 10 hepatocellular adenomas defines hepatic adenomatosis. The diagnosis may be established incidentally during a liver radiologic examination in the asymptomatic patient, or after associated right upper quadrant pain, hepatomegaly or liver test abnormalities. Upon the diagnosis of hepatic adenomatosis or either of its life-threatening complications - hemorrhage and progression to hepatocellular carcinoma - consideration should be given to potential medical, radiologic and surgical interventions including: observation (estrogens and androgens withdrawal), resection, transarterial embolization, radiofrequency ablation and liver transplantation. The management of patients with hepatic adenomatosis can be challenging. These patients should be ideally referred to centers with expertise in the management of liver diseases.
肝腺瘤病和肝细胞腺瘤具有共同的危险因素和相同的病理生理谱。肝脏中存在10个肝细胞腺瘤可定义为肝腺瘤病。诊断可在无症状患者的肝脏影像学检查中偶然发现,或在出现相关的右上腹疼痛、肝肿大或肝功能检查异常后作出。一旦诊断为肝腺瘤病或其任何一种危及生命的并发症——出血和进展为肝细胞癌,应考虑潜在的医学、放射学和外科干预措施,包括:观察(停用雌激素和雄激素)、切除、经动脉栓塞、射频消融和肝移植。肝腺瘤病患者的管理可能具有挑战性。这些患者理想情况下应转诊至在肝病管理方面具有专业知识的中心。