Leese T, Farges O, Bismuth H
Hepatobiliary Unit, Hôpital Paul Brousse, Villejuif, France.
Ann Surg. 1988 Nov;208(5):558-64. doi: 10.1097/00000658-198811000-00003.
Twenty-four patients with liver cell adenomas were referred to Paul Brousse Hospital between 1976 and 1987. This represents the largest reported surgical experience of this pathology from a single centre. Six patients had multiple adenomas, which were associated with glycogen storage disease in four. Two patients had polyadenomatosis, one of whom underwent successful liver transplantation after malignant transformation to hepatocellular carcinoma. Eighteen patients (median age of 33 years, range of 17-45 years) had either a solitary adenoma or two adenomas. Eighty-three per cent were women 87% of whom had received oral contraceptives or other hormone therapy before diagnosis (median duration of 11 years, range of 3-15 years). Fifty per cent of these patients presented with acute hemorrhage into an adenoma. Seventeen patients underwent surgical resection of their adenomas, with the remaining patient currently being treated by arterial embolizations to reduce the tumor size before surgery. There was no operative mortality or serious morbidity, and all patients remain well upon follow-up. Surgical excision of liver adenomas, where this can be done without causing mortality, is recommended. Resection relieves symptoms and removes both the risks of hemorrhaging into the tumour and of malignant transformation to hepatocellular carcinoma.
1976年至1987年间，24例肝细胞腺瘤患者被转诊至保罗·布罗斯医院。这是单个中心报告的关于这种病理情况的最大规模手术经验。6例患者有多个腺瘤，其中4例与糖原贮积病相关。2例患者有多发性腺瘤病，其中1例在恶变为肝细胞癌后接受了成功的肝移植。18例患者（中位年龄33岁，范围17 - 45岁）有单个腺瘤或两个腺瘤。83%为女性，其中87%在诊断前接受过口服避孕药或其他激素治疗（中位持续时间11年，范围3 - 15年）。这些患者中有50%表现为腺瘤急性出血。17例患者接受了腺瘤的手术切除，其余患者目前正在接受动脉栓塞治疗以在手术前缩小肿瘤大小。无手术死亡或严重并发症，所有患者在随访中情况良好。建议在不导致死亡的情况下对肝腺瘤进行手术切除。切除可缓解症状，并消除肿瘤内出血和恶变为肝细胞癌的风险。
