Hepatic (Liver) Adenoma Formation and Treatment

Table of ContentsView AllTable of ContentsSymptomsConnection to Birth ControlTestingTreatmentSurgery RecoveryStatistics on Recurrence

Table of ContentsView All

View All

Table of Contents

Symptoms

Connection to Birth Control

Testing

Treatment

Surgery Recovery

Statistics on Recurrence

Hepatic adenoma is an uncommon type of non-cancerous tumor that forms in the liver, usually occurring in younger women with a history of oral birth control use.People often find out they have one when they get imaging tests like ultrasounds, magnetic resonance imaging scans (MRIs), or computed tomography (CT) scans for other health reasons.

About 50% of the time, these tumors don’t cause any symptoms, so many people don’t even realize they have one until it shows up on a scan.Even though hepatic adenomas are benign, they can still cause problems, like bursting or becoming cancerous.

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Hepatic adenomas often do not cause symptoms, so they can go unnoticed for long periods. However, if they grow large enough or if complications arise, some individuals may experience:

In rare cases, adenomas can rupture, causing symptoms like:

Hepatic Adenoma and Birth Control: What’s the Link?

Research has shown a strong association between the development of hepatic adenomas and the use of hormonal contraceptives, particularly those containing higher doses of estrogen.In addition, stopping the oral contraceptive often leads to tumor regression.

Tumor Formation

Research has shown that using estrogen over a long period can increase the risk of developing liver tumors, including hepatic adenomas.

There are three molecular pathways involved in the development of hepatocellular adenoma:

Women who take oral contraceptives have a similar risk for all three types of hepatic adenomas. While there have been rare cases where a hepatic adenoma turned into a more severe cancer called hepatocellular carcinoma (HCC), studies have not found strong evidence linking the use of oral contraceptives to an increased risk of HCC.

Other Risk Factors

Aside from hormonal influences, several other factors may be associated with developing hepatic adenomas, including:

Awareness of these risk factors can help individuals and healthcare providers identify those who may benefit from regular monitoring.

Testing and Radiology Findings

When hepatic adenomas are suspected, imaging studies are crucial for diagnosis and evaluation. Here are the primary modalities used in the assessment of hepatic lesions:

If a hepatic adenoma is diagnosed, additional imaging may be required to monitor its size and behavior over time. Regular imaging follow-ups can ensure that any changes are detected early.

The management of hepatic adenomas largely depends on their size, symptoms, and the individual’s overall health. For hepatic adenomas that are smaller than 5 centimeters (cm) and linked to oral contraceptive use, healthcare providers usually take a careful approach. They may suggest stopping the birth control pills and regularly checking the tumor using imaging tests like ultrasounds or MRIs. Many times, this can help the tumor shrink over time.

During pregnancy, most small adenomas don’t change much, and women with these tumors are generally not discouraged from getting pregnant.

When Providers Consider Removal

Surgical intervention may be warranted under certain conditions, such as:

Surgery to remove the adenoma is typically recommended for all men, no matter how big the tumor is. This is because men are more likely to have adenomas that can cause cancer.The surgery for removing the tumor is considered a safe and effective treatment. However, it will only be done if necessary since all surgery carries some risk.

The main surgical options for treating hepatic adenomas are:

Recovery from surgery for hepatic adenoma can vary based on the individual’s overall health, the surgical technique used, and the size of the tumor. Here are some general recovery considerations:

The outlook for people with hepatocellular adenoma (HCA) is not well understood. Stopping oral contraceptives can sometimes shrink or heal the tumor. Surgical resection may significantly reduce the likelihood of recurrence.

In a study of 118 people who had surgery to remove hepatic adenomas, 8% had the tumor come back or get bigger. For the 10 patients whose tumors became cancerous, there were no signs of cancer returning after an average follow-up period of 78 months.

Summary

If you or a loved one has been diagnosed with a hepatic adenoma, discussing your specific situation and treatment options with your healthcare provider is essential to ensure the best possible outcome.

18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wang X, Zhang X.Hepatocellular adenoma: where are we now?WJG. 2022;28(14):1384-1393. doi:10.3748/wjg.v28.i14.1384Baker FA, Zeina AR, Mouch SA, Mari A.Benign hepatic tumors: from incidental imaging finding to clinical management.Korean J Fam Med. 2021;42(1):2-8. doi:10.4082/kjfm.18.0188British Liver Trust.Hepatocellular adenoma.American Liver Foundation.Benign liver tumors.Haring MPD, Gouw ASH, de Haas RJ, Cuperus FJC, de Jong KP, de Meijer VE.The effect of oral contraceptive pill cessation on hepatocellular adenoma diameter: a retrospective cohort study.Liver Int. 2019;39(5):905-913. doi:10.1111/liv.14074.Villa E.Role of estrogen in liver cancer.Womens Health. 2008;4(1):41-50. doi:10.2217/17455057.4.1.41Liver Fellow Network.What is THAT on your liver?American Cancer Society.Tests for liver cancer.Jacob DK.Hepatic adenoma.Radiopaedia.Wong VK, Fung AW, Elsayes KM.Magnetic resonance imaging of hepatic adenoma subtypes.Clinical Liver Disease. 2021;17(3):113-118. doi:10.1002/cld.996Noels JE, van Aalten SM, van der Windt DJ, et al.Management of hepatocellular adenoma during pregnancy.J Hepatol. 2011;54(3):553-558. doi:10.1016/j.jhep.2010.07.022Thomeer MG, Broker M, Verheij J, et al.Hepatocellular adenoma: when and how to treat? Update of current evidence.Therapeutic Advances in Gastroenterology. 2016;9(6):898.de’Angelis N, Memeo R, Calderaro J, et al.Open and laparoscopic resection of hepatocellular adenoma: trends over 23 years at a specialist hepatobiliary unit.HPB (Oxford). 2014;16(9):783-788. doi:10.1111/hpb.12257Viganò L, Elamin A, Costa G.Hepatic adenoma: indications for minimally invasive resection.Laparoscopic Surgery. 2019;3.van Rosmalen BV, Klompenhouwer AJ, de Graeff JJ, et al.Safety and efficacy of transarterial embolization of hepatocellular adenomas.Br J Surg. 2019;106(10):1362-1371. doi:10.1002/bjs.11213Savikko J, Vikatmaa L, Hiltunen AM, et al.Enhanced recovery protocol in laparoscopic liver surgery.Surg Endosc.2021;35(3):1058-1066. doi:10.1007/s00464-020-07470-2Chopinet S, Cauchy F, Hobeika C, et al.Long-term outcomes following resection of hepatocellular adenomas with small foci of malignant transformation or malignant adenomas.JHEP Rep. 2021;3(4):100326. doi:10.1016/j.jhepr.2021.100326Dokmak S, Paradis V, Vilgrain V, et al.A single-center surgical experience of 122 patients with single and multiple hepatocellular adenomas.Gastroenterology.2009;137(5):1698-1705.

18 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wang X, Zhang X.Hepatocellular adenoma: where are we now?WJG. 2022;28(14):1384-1393. doi:10.3748/wjg.v28.i14.1384Baker FA, Zeina AR, Mouch SA, Mari A.Benign hepatic tumors: from incidental imaging finding to clinical management.Korean J Fam Med. 2021;42(1):2-8. doi:10.4082/kjfm.18.0188British Liver Trust.Hepatocellular adenoma.American Liver Foundation.Benign liver tumors.Haring MPD, Gouw ASH, de Haas RJ, Cuperus FJC, de Jong KP, de Meijer VE.The effect of oral contraceptive pill cessation on hepatocellular adenoma diameter: a retrospective cohort study.Liver Int. 2019;39(5):905-913. doi:10.1111/liv.14074.Villa E.Role of estrogen in liver cancer.Womens Health. 2008;4(1):41-50. doi:10.2217/17455057.4.1.41Liver Fellow Network.What is THAT on your liver?American Cancer Society.Tests for liver cancer.Jacob DK.Hepatic adenoma.Radiopaedia.Wong VK, Fung AW, Elsayes KM.Magnetic resonance imaging of hepatic adenoma subtypes.Clinical Liver Disease. 2021;17(3):113-118. doi:10.1002/cld.996Noels JE, van Aalten SM, van der Windt DJ, et al.Management of hepatocellular adenoma during pregnancy.J Hepatol. 2011;54(3):553-558. doi:10.1016/j.jhep.2010.07.022Thomeer MG, Broker M, Verheij J, et al.Hepatocellular adenoma: when and how to treat? Update of current evidence.Therapeutic Advances in Gastroenterology. 2016;9(6):898.de’Angelis N, Memeo R, Calderaro J, et al.Open and laparoscopic resection of hepatocellular adenoma: trends over 23 years at a specialist hepatobiliary unit.HPB (Oxford). 2014;16(9):783-788. doi:10.1111/hpb.12257Viganò L, Elamin A, Costa G.Hepatic adenoma: indications for minimally invasive resection.Laparoscopic Surgery. 2019;3.van Rosmalen BV, Klompenhouwer AJ, de Graeff JJ, et al.Safety and efficacy of transarterial embolization of hepatocellular adenomas.Br J Surg. 2019;106(10):1362-1371. doi:10.1002/bjs.11213Savikko J, Vikatmaa L, Hiltunen AM, et al.Enhanced recovery protocol in laparoscopic liver surgery.Surg Endosc.2021;35(3):1058-1066. doi:10.1007/s00464-020-07470-2Chopinet S, Cauchy F, Hobeika C, et al.Long-term outcomes following resection of hepatocellular adenomas with small foci of malignant transformation or malignant adenomas.JHEP Rep. 2021;3(4):100326. doi:10.1016/j.jhepr.2021.100326Dokmak S, Paradis V, Vilgrain V, et al.A single-center surgical experience of 122 patients with single and multiple hepatocellular adenomas.Gastroenterology.2009;137(5):1698-1705.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Wang X, Zhang X.Hepatocellular adenoma: where are we now?WJG. 2022;28(14):1384-1393. doi:10.3748/wjg.v28.i14.1384Baker FA, Zeina AR, Mouch SA, Mari A.Benign hepatic tumors: from incidental imaging finding to clinical management.Korean J Fam Med. 2021;42(1):2-8. doi:10.4082/kjfm.18.0188British Liver Trust.Hepatocellular adenoma.American Liver Foundation.Benign liver tumors.Haring MPD, Gouw ASH, de Haas RJ, Cuperus FJC, de Jong KP, de Meijer VE.The effect of oral contraceptive pill cessation on hepatocellular adenoma diameter: a retrospective cohort study.Liver Int. 2019;39(5):905-913. doi:10.1111/liv.14074.Villa E.Role of estrogen in liver cancer.Womens Health. 2008;4(1):41-50. doi:10.2217/17455057.4.1.41Liver Fellow Network.What is THAT on your liver?American Cancer Society.Tests for liver cancer.Jacob DK.Hepatic adenoma.Radiopaedia.Wong VK, Fung AW, Elsayes KM.Magnetic resonance imaging of hepatic adenoma subtypes.Clinical Liver Disease. 2021;17(3):113-118. doi:10.1002/cld.996Noels JE, van Aalten SM, van der Windt DJ, et al.Management of hepatocellular adenoma during pregnancy.J Hepatol. 2011;54(3):553-558. doi:10.1016/j.jhep.2010.07.022Thomeer MG, Broker M, Verheij J, et al.Hepatocellular adenoma: when and how to treat? Update of current evidence.Therapeutic Advances in Gastroenterology. 2016;9(6):898.de’Angelis N, Memeo R, Calderaro J, et al.Open and laparoscopic resection of hepatocellular adenoma: trends over 23 years at a specialist hepatobiliary unit.HPB (Oxford). 2014;16(9):783-788. doi:10.1111/hpb.12257Viganò L, Elamin A, Costa G.Hepatic adenoma: indications for minimally invasive resection.Laparoscopic Surgery. 2019;3.van Rosmalen BV, Klompenhouwer AJ, de Graeff JJ, et al.Safety and efficacy of transarterial embolization of hepatocellular adenomas.Br J Surg. 2019;106(10):1362-1371. doi:10.1002/bjs.11213Savikko J, Vikatmaa L, Hiltunen AM, et al.Enhanced recovery protocol in laparoscopic liver surgery.Surg Endosc.2021;35(3):1058-1066. doi:10.1007/s00464-020-07470-2Chopinet S, Cauchy F, Hobeika C, et al.Long-term outcomes following resection of hepatocellular adenomas with small foci of malignant transformation or malignant adenomas.JHEP Rep. 2021;3(4):100326. doi:10.1016/j.jhepr.2021.100326Dokmak S, Paradis V, Vilgrain V, et al.A single-center surgical experience of 122 patients with single and multiple hepatocellular adenomas.Gastroenterology.2009;137(5):1698-1705.

Wang X, Zhang X.Hepatocellular adenoma: where are we now?WJG. 2022;28(14):1384-1393. doi:10.3748/wjg.v28.i14.1384

Baker FA, Zeina AR, Mouch SA, Mari A.Benign hepatic tumors: from incidental imaging finding to clinical management.Korean J Fam Med. 2021;42(1):2-8. doi:10.4082/kjfm.18.0188

British Liver Trust.Hepatocellular adenoma.

American Liver Foundation.Benign liver tumors.

Haring MPD, Gouw ASH, de Haas RJ, Cuperus FJC, de Jong KP, de Meijer VE.The effect of oral contraceptive pill cessation on hepatocellular adenoma diameter: a retrospective cohort study.Liver Int. 2019;39(5):905-913. doi:10.1111/liv.14074.

Villa E.Role of estrogen in liver cancer.Womens Health. 2008;4(1):41-50. doi:10.2217/17455057.4.1.41

Liver Fellow Network.What is THAT on your liver?

American Cancer Society.Tests for liver cancer.

Jacob DK.Hepatic adenoma.Radiopaedia.

Wong VK, Fung AW, Elsayes KM.Magnetic resonance imaging of hepatic adenoma subtypes.Clinical Liver Disease. 2021;17(3):113-118. doi:10.1002/cld.996

Noels JE, van Aalten SM, van der Windt DJ, et al.Management of hepatocellular adenoma during pregnancy.J Hepatol. 2011;54(3):553-558. doi:10.1016/j.jhep.2010.07.022

Thomeer MG, Broker M, Verheij J, et al.Hepatocellular adenoma: when and how to treat? Update of current evidence.Therapeutic Advances in Gastroenterology. 2016;9(6):898.

de’Angelis N, Memeo R, Calderaro J, et al.Open and laparoscopic resection of hepatocellular adenoma: trends over 23 years at a specialist hepatobiliary unit.HPB (Oxford). 2014;16(9):783-788. doi:10.1111/hpb.12257

Viganò L, Elamin A, Costa G.Hepatic adenoma: indications for minimally invasive resection.Laparoscopic Surgery. 2019;3.

van Rosmalen BV, Klompenhouwer AJ, de Graeff JJ, et al.Safety and efficacy of transarterial embolization of hepatocellular adenomas.Br J Surg. 2019;106(10):1362-1371. doi:10.1002/bjs.11213

Savikko J, Vikatmaa L, Hiltunen AM, et al.Enhanced recovery protocol in laparoscopic liver surgery.Surg Endosc.2021;35(3):1058-1066. doi:10.1007/s00464-020-07470-2

Chopinet S, Cauchy F, Hobeika C, et al.Long-term outcomes following resection of hepatocellular adenomas with small foci of malignant transformation or malignant adenomas.JHEP Rep. 2021;3(4):100326. doi:10.1016/j.jhepr.2021.100326

Dokmak S, Paradis V, Vilgrain V, et al.A single-center surgical experience of 122 patients with single and multiple hepatocellular adenomas.Gastroenterology.2009;137(5):1698-1705.

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