Hepatocellular Adenoma | Can Hepatic Adenomas Become Cancerous?

Hepatocellular adenoma is a benign liver tumor. Benign liver tumors affect more than 20% of humans and mostly go undetected. There are three common benign liver tumors which are: hemangiomas, focal nodular hyperplasia and hepatocellular adenoma. Hepatocellular adenoma is less common than hemangioma and focal nodular hyperplasia, and usually affects women. Most benign tumors have no potential of turning malignant but hepatocellular adenoma has the highest probability of turning malignant among benign liver tumors. Another complication that can occur is its rupture which can cause severe bleeding inside the abdominal cavity. Rupture often occurs in pregnant females, which points towards a hormonal cause for the tumor.

Contrary to other benign tumors, hepatocellular adenoma has a strong link to oral contraceptive pills. Females who take OCPs are at a greater risk than those who don’t, and those who already have the tumor can cause it to enlarge by taking OCPs. Men are unlikely to have it and if they do, liver cancer should be suspected. Steroids whether oral or injectable have also been implicated in causing hepatocellular adenoma.

Symptoms of hepatocellular adenoma

There is a great variation of symptoms and signs between patients who have hepatocellular adenoma. The most common symptoms are:

  • Abdominal pain: Abdominal pain from hepatocellular adenoma is centred in the upper right abdomen where the liver is. It is usually dull and can sometimes extend to the upper middle abdomen where the left lobe of the liver is.
  • Acute abdominal pain can occur at the same site if haemorrhage occurs. The pain is so severe that most patients go the ER once it starts.
  • Bloating or feeling of heaviness: when the mass is large, it compresses the stomach and causes a feeling of fullness and early satiety.
  • Symptoms of liver disease: It is extremely rare for patients with hepatocellular adenoma to have liver impairment. However, if a benign tumor is large enough, it can cause the healthy liver to be smaller and, therefore, impair its function. Symptoms include jaundice, abdominal distension and muscle wasting.
  • Feeling of a mass: Usually, hepatocellular adenoma is small enough that it cannot be felt neither by the patient nor by the physician, but in some cases, it can enlarge enough to be felt as a firm mass in the right upper abdomen.

Written by Martin Davis