Diagnosis of hepatocellular adenoma in men before onset of diabetes in HNF1A‐MODY: Watch out for winkers

Haring, Martijn P D; Vriesendorp, Titia M.; Wassink-Ruiter, Jolien S. Klein; Haas, Robbert J. de; Gouw, Annette; Meijer, Vincent E de

doi:10.1111/liv.14235

Cited by 10 publications

(8 citation statements)

References 20 publications

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“…Anabolic steroid use is another hormonal risk factor for the development of HCAs 16–19 . Obesity, metabolic syndrome, 20–26 vascular liver diseases (VLDs), 27–31 genetic diseases 32–43 and alcohol consumption 7 have also been identified as predisposing factors. Table 1 summarises the main risk factors, including several liver diseases associated with HCAs 44,45 .…”

Section: Risk Factorsmentioning

confidence: 99%

Hepatocellular adenoma: what we know, what we do not know, and why it matters

et al. 2022

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Hepatocellular adenoma: what we know, what we do not know, and why it mattersIn the last two decades there has been significant progress in research on and diagnosis of hepatocellular adenoma (HCA), resulting in the establishment of a molecular and immunohistological HCA classification. This review aims to fine-tune the current expertise in order to enhance the histopathological diagnostic possibilities, by refining issues that are already known, addressing diagnostic difficulties, and identifying still unknown aspects of HCA. We discuss novel methods to identify HCA subtypes, in particular the sonic hedgehog HCAs and the interpretation of glutamine synthetase patterns for the recognition of b-cateninmutated HCAs. The major complications of HCAs, i.e. bleeding and malignant transformation, are considered, including the dilemmas of atypical and borderline lesions. HCAs in different clinical and geographical settings, e.g. pregnancy, cirrhosis and non-western countries, are also discussed. The natural history of the different HCA subtypes in relation to age, sex and risk factors is a feature that is still insufficiently investigated. This is also true for the risks of clinical bleeding and malignant transformation in association with HCA subtypes. As HCA is a relatively rare tumour, a multicentre and multidisciplinary approach across geographical boundaries will be the appropriate method to establish prospective programmes with which to identify, classify and manage HCAs, focusing on several aspects, e.g. aetiology, underlying liver disease, complications, regression, and growth. Updating what we know and identifying and addressing what we do not know matters for optimal patient management.

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Section: Risk Factorsmentioning

confidence: 99%

Hepatocellular adenoma: what we know, what we do not know, and why it matters

et al. 2022

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“…1 The female predisposition is due to the association of the tumor with high serum estrogen states such as pregnancy and use of oral contraceptive medication and hormone replacement therapy. The tumor may also arise in males with the use of anabolic steroids 2 , barbiturates, or due to underlying metabolic diseases such as glycogen storage disease type 1 and type 3 3 , type 1 diabetes mellitus 4 , hemochromatosis, and tyrosinemia. In rare instances, HA may arise in an otherwise healthy male with no associated underlying risk factors for hepatic adenoma.…”

Section: Introductionmentioning

confidence: 99%

Hepatic Adenomatosis in a 32-Year-Old Male With No Risk Factors for Hepatic Adenoma

Malik

Akram

2022

J Ayub Med Coll Abbottabad

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Hepatic Adenomatosis most commonly arises in the background of hepatic adenoma in young women and less commonly in men with underlying risk factors. Rarely, it can arise in young men with none of the associated risk factors and thus can go undetected for a prolonged period resulting in delayed intervention and avoidable complications. We present a rare case of a 32-year-old asymptomatic male that presented for routine evaluation and was subsequently diagnosed with Hepatic Adenomatosis.

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“…Currently, none of the guidelines provided recommendations on HCA in patients with HNF1A-MODY or GSD, while although rare, these are known for their high HCA prevalence. 17 Additionally, no large series on molecular HCA subtypes and behaviour in men have been performed, nor has the role of artificial intelligence in BLT characterisation extensively been explored.…”

Section: Discussionmentioning

confidence: 99%

“…15 Adenomatosis (≥10 HCA) is associated with metabolic disorders such as HNF1A maturity onset diabetes of the young and glycogen storage disease (GSD). 17 18 B-catenin activated HCA (b-HCA; 10%) are at increased risk for malignant transformation to hepatocellular carcinoma (HCC) and more often occur in men. Importantly, half of b-HCA are hybrid b-catenin/inflammatory HCA.…”

Section: Introductionmentioning

confidence: 99%

Scoping review of clinical practice guidelines on the management of benign liver tumours

Haring

Cuperus

Duiker

et al. 2021

BMJ Open Gastroenterol

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ObjectiveBenign liver tumours (BLT) are increasingly diagnosed as incidentalomas. Clinical implications and management vary across and within the different types of BLT. High-quality clinical practice guidelines are needed, because of the many nuances in tumour types, diagnostic modalities, and conservative and invasive management strategies. Yet, available observational evidence is subject to interpretation which may lead to practice variation. Therefore, we aimed to systematically search for available clinical practice guidelines on BLT, to critically appraise them, and to compare management recommendations.DesignA scoping review was performed within MEDLINE, EMBASE, and Web of Science. All BLT guidelines published in peer-reviewed, and English language journals were eligible for inclusion. Clinical practice guidelines on BLT were analysed, compared, and critically appraised using the Appraisal of Guidelines, Research and Evaluation (AGREE II) checklist regarding hepatic haemangioma, focal nodular hyperplasia (FNH), and hepatocellular adenoma (HCA). Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations (PRISMA) for scoping reviews were adhered to.ResultsThe literature search yielded unique 367 papers, 348 were excluded after screening of title/abstract, and 16 after full-text screening. Three guidelines were included: the American College of Gastroenterology (ACG; 2014), Brazilian Society of Hepatology (SBH; 2015), and European Association for the Study of the Liver (EASL; 2016). There was no uniformity in the assessment methods for grading and gravity of recommendations between guidelines. Among observed differences were: (1) indications for biopsy in all three tumours; (2) advices on contraceptive pills and follow-up in FNH and HCA; (3) use of an individualised approach to HCA; (4) absence of recommendations for treatment of HCA in men; and (5) approaches to HCA subtype identification on magnetic resonance imaging.ConclusionRecognising differences in recommendations can assist in harmonisation of practice standards and identify unmet needs in research. This may ultimately contribute to improved global patient care.

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Diagnosis of hepatocellular adenoma in men before onset of diabetes in HNF1A‐MODY: Watch out for winkers

Cited by 10 publications

References 20 publications

Hepatocellular adenoma: what we know, what we do not know, and why it matters

Hepatocellular adenoma: what we know, what we do not know, and why it matters

Hepatic Adenomatosis in a 32-Year-Old Male With No Risk Factors for Hepatic Adenoma

Scoping review of clinical practice guidelines on the management of benign liver tumours

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