Hepkema Joris T, Poelmann Floris B, Gouw Annette S H, de Haas Robbert J, Duiker Evelien W, Blokzijl Hans, Klaase Joost M
Division of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Medical Biology and Pathology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Case Rep Gastroenterol. 2020 Nov 2;14(3):577-585. doi: 10.1159/000510215. eCollection 2020 Sep-Dec.
Hepatocellular adenomas (HCA) are rare benign tumors of the liver, occurring predominantly in females using oral contraceptives. Our case describes a 66-year-old woman presenting with a palpable mass in her upper abdomen. Contrast-enhanced computed tomography and magnetic resonance imaging showed a large exophytic mass protruding from the caudal border of liver segments IV and V, without visible metastases. Laparoscopic resection of the tumor and gallbladder was performed. Histopathological examination showed a hepatocellular carcinoma with areas of HNF1a-HCA (H-HCA). This case shows that malignant transformation is possible in H-HCA. We present our preoperative decision-making process, as well as the role of imaging techniques in this rare case.
肝细胞腺瘤（HCA）是肝脏罕见的良性肿瘤，主要发生在使用口服避孕药的女性中。我们的病例描述了一名66岁女性，上腹部可触及肿块。对比增强计算机断层扫描和磁共振成像显示，一个巨大的外生性肿块从肝段IV和V的尾侧边缘突出，未见转移。对肿瘤和胆囊进行了腹腔镜切除。组织病理学检查显示为肝细胞癌伴HNF1a-HCA（H-HCA）区域。该病例表明H-HCA可能发生恶变。我们展示了术前决策过程以及影像技术在这个罕见病例中的作用。
