Lopes Sara Ramos, Santos Inês Costa, Teixeira Madalena, Sequeira Cristiana, Carvalho Ana Maria, Gamito Élia
Gastrenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal.
Pathology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal.
GE Port J Gastroenterol. 2024 Apr 2;31(6):443-448. doi: 10.1159/000538340. eCollection 2024 Dec.
Hepatocellular adenoma is a rare benign liver tumor that occurs predominantly in young women who use exogenous estrogens. We describe a case of a 40-year-old woman on birth control pill who presented with acute right hypochondrial pain and signs of hemodynamical instability triggered by a large bleeding tumor in the right liver lobe. Arterial embolization was performed with cessation of bleeding. To determine etiology, magnetic resonance imaging was conducted with findings suggestive of a hepatocellular adenoma. The tumor was surgically resected, and histologic examination made the definite diagnosis of an inflammatory hepatocellular adenoma. This is a noteworthy case of a rare but potentially fatal complication of liver tumors, whose diagnosis requires a high index of suspicion. Clinicians should consider this diagnosis in young women on oral contraceptive pills who present with severe unexplained abdominal pain and hemodynamical instability. This case aimed to raise awareness of this condition, while reviewing important aspects concerning the management of hepatocellular adenomas.
肝细胞腺瘤是一种罕见的良性肝脏肿瘤,主要发生在使用外源性雌激素的年轻女性中。我们描述了一例40岁服用避孕药的女性病例,该患者因右肝叶巨大出血性肿瘤引发急性右季肋部疼痛和血流动力学不稳定体征。通过动脉栓塞实现了止血。为确定病因,进行了磁共振成像检查,结果提示为肝细胞腺瘤。肿瘤经手术切除,组织学检查确诊为炎症性肝细胞腺瘤。这是一例值得关注的病例,肝脏肿瘤虽罕见但可能致命,其诊断需要高度怀疑指数。临床医生对于出现严重不明原因腹痛和血流动力学不稳定的口服避孕药年轻女性应考虑这一诊断。本病例旨在提高对这种情况的认识,同时回顾肝细胞腺瘤管理的重要方面。