Hepatic adenoma:

– primarily affects young women of childbearing age (20-40 years)

– often have a long history of using oral contraceptives (can regress after discontinuing but not consistently)

– also associated with anabolic steroid use,  insulin-dependent diabetes and type 1a glycogen storage disease

– most commopn complication is intratumoral or intraperitoneal haemorrhage (occurs in 50-60% of patients)

– can undergo malignant transformation, can be detected by AFP

– elective resection has mortality of <1% but with rupture its 5-10%

– range in size from 1-30cm, average 8-10cm; the tumours are usually subcapsular, have superficial projections, occasionally pedunculated and are never nodular or fibrotic.

– normally hypervascular on CT and MRE but some can by hypovascular.

– contain vacuoles and glycogen but no Kupfer cells or bile ducts

– usually symptomatic causing pressure or haemorrhage

– can progress to adenomatosis which is inoperable or undergo malignant transformation

– only fine needle aspiration is advised for biopsy due to risk of haemorrhage