Hepatocellular adenomas (HCAs), referred to as liver adenomas, are rare, typically benign hepatic tumors arising from hepatocytes. Nevertheless, they carry potential risks of hemorrhage and malignant transformation. HCAs are generally linked to hormonal stimulation (e.g., estrogen) and are predominantly seen in young women, especially among young and middle-aged females using oral contraceptives. This paper reports a case of giant HCA in an adolescent male and analyzes its tumor characteristics to differentiate it from other easily confusable liver neoplasms, so as to provide a reference for further enhancing clinical awareness of HCAs and facilitating their early detection and treatment.

1.高维克, 戴朝六. 肝腺瘤的临床特点、诊断及治疗(附11例报告)[J], 山东医药, 2018, 58(7): 70-72. [Gao WK, Dai CL. Clinical characteristics, diagnosis and treatment of hepatic adenoma (report of 11 cases)[J]. Shandong Medical Journal, 2018, 58(7): 70-72.].https://sdyy.cbpt.cnki.net/portal/journal/portal/client/paper/331af1c338e3500507d3d9d607f36986

2.Sempoux C, Paradis V, Komuta M, et al. Hepatocellular nodules expressing markers of hepatocellular adenomas in Budd-Chiari syndrome and other rare hepatic vascular disorders[J]. J Hepatol, 2015, 63(5): 1173-1180. DOI: 10.1016/j.jhep.2015.06.017.

3.Labrune P, Trioche P, Duvaltier I, et al. Hepatocellular adenomas in glycogen storage disease type I and III: a series of 43 patients and review of the literature[J]. J Pediatr Gastroenterol Nutr, 1997, 24(3): 276-279. DOI: 10.1097/00005176-199703000-00008.

4.Dokmak S, Belghiti J. Will weight loss become a future treatment of hepatocellular adenoma in obese patients?[J]. Liver Int, 2015, 35(10): 2228-2232. DOI: 10.1111/liv.12925.

5.Nault JC, Fabre M, Couchy G, et al. GNAS-activating mutations define a rare subgroup of inflammatory liver tumors characterized by STAT3 activation[J]. J Hepatol, 2012, 56(1): 184-191. DOI: 10.1016/j.jhep.2011.07.018.

6.Socas L, Zumbado M, Pérez-Luzardo O, et al. Hepatocellular adenomas associated with anabolic androgenic steroid abuse in bodybuilders: a report of two cases and a review of the literature[J]. Br J Sports Med, 2005, 39(5): e27. DOI: 10.1136/bjsm.2004.013599.

7.Liau SS, Qureshi MS, Praseedom R, et al. Molecular pathogenesis of hepatic adenomas and its implications for surgical management[J]. J Gastrointest Surg, 2013, 17(10): 1869-1882. DOI: 10.1007/s11605-013-2274-6.

8.Rooks JB, Ory HW, Ishak KG, et al. Epidemiology of hepatocellular adenoma. The role of oral contraceptive use[J]. JAMA, 1979, 242(7): 644-648. https://pubmed.ncbi.nlm.nih.gov/221698/.

9.Lin H, van den Esschert J, Liu C, et al. Systematic review of hepatocellular adenoma in China and other regions[J]. J Gastroenterol Hepatol, 2011, 26(1): 28-35. DOI: 10.1111/j.1440-1746.2010.06502.x.

10.Liau SS, Qureshi MS, Praseedom R, et al. Molecular pathogenesis of hepatic adenomas and its implications for surgical management[J]. J Gastrointest Surg, 2013, 17(10): 1869-1882. DOI: 10.1007/s11605-013-2274-6.

11.Klambauer K, Cecatka S, Clevert DA. Ultraschalldiagnostik der leber: grundlagen und wichtige pathologien [Ultrasound diagnostics of the liver: principles and important pathologies][J]. Radiologie (Heidelb), 2023, 63(5): 387-402. DOI: 10.1007/s00117-023-01138-3.

12.郁义星, 林晓珠, 陈克敏, 等. CT能谱成像在鉴别肝癌和局灶结节增生中的价值[J]. 中华放射学杂志, 2013, 47(2): 121-126. [Yu YX, Lin XZ, Chen KM, et al. Values of spectral CT imaging in differential diagnosis of hepatocellular carcinoma and focal nodular hyperplasia[J]. Chinese Journal of Radiology, 2013, 47(2): 121-126. ] DOI: 10.3760/cma.j.issn.1005-1201.2013.02.006.

13.Denecke T, Steffen IG, Agarwal S, et al. Appearance of hepatocellular adenomas on gadoxetic acid-enhanced MRI[J]. Eur Radiol, 2012, 22(8): 1769-1775. DOI: 10.1007/s00330-012-2422-5.

14.Brancatelli G, Federle MP, Vullierme MP,,et al. CT and MR imaging evaluation of hepatic adenoma[J]. J Comput Assist Tomogr, 2006, 30(5): 745-750. DOI: 10.1097/01.rct.0000224630.48068.bf.

15.Zucman-Rossi J, Jeannot E, Nhieu JT,et al. Genotype-phenotype correlation in hepatocellular adenoma: new classification and relationship with HCC[J]. Hepatology, 2006, 43(3): 515-524. DOI: 10.1002/hep.21068.

16.Bioulac-Sage P, Laumonier H, Couchy G, et al. Hepatocellular adenoma management and phenotypic classification: the Bordeaux experience[J]. Hepatology, 2009, 50(2): 481-489. DOI: 10.1002/hep.22995.

17.黄成. 2016年欧洲肝病学会临床实践指南:肝脏良性肿瘤的管理[J]. 临床肝胆病杂志, 2016, 32(8): 1439-1445. [Huang C. EASL Clinical practice guidelines on the management of benign liver tumours (2016)[J]. Journal of Clinical Hepatology, 2016, 32(8): 1439-1445. ] DOI: 10.3969/j.issn.1001-5256.2016.08.001

18.Ahn SY, Park SY, Kweon YO, et al. Successful treatment of multiple hepatocellular adenomas with percutaneous radiofrequency ablation[J]. World J Gastroenterol, 2013, 19(42): 7480-7486. DOI: 10.3748/wjg.v19.i42.7480.

19.Mironov O, Jaberi A, Beecroft R, et al. Retrospective single-arm cohort study of patients with hepatocellular adenomas treated with percutaneous thermal ablation[J]. Cardiovasc Intervent Radiol, 2018, 41(6): 935-941. DOI: 10.1007/s00270-018-1893-4.

20.Sinkler MA, Bosley M. Massive hepatic adenoma response to bland embolization: a case study[J]. Radiol Case Rep, 2018, 14(1): 48-51. DOI: 10.1016/j.radcr.2018.09.016.

21.Deodhar A, Brody LA, Covey AM, et al. Bland embolization in the treatment of hepatic adenomas: preliminary experience[J]. J Vasc Interv Radiol, 2011, 22(6): 795-799. DOI: 10.1016/j.jvir.2011.02.027.

22.Sundar Alagusundaramoorthy S, Vilchez V, Zanni A, et al. Role of transplantation in the treatment of benign solid tumors of the liver: a review of the United Network of Organ Sharing data set[J]. JAMA Surg, 2015, 150(4): 337-342. DOI: 10.1001/jamasurg.2014.3166.