Hepatic Cell Adenoma: Spontaneous Rupture during Pregnancy

Tsang, Verne; Halliday, Alison; Collier, Neil A.; Benjamin, Israel; Blumgart, Leslie H.

doi:10.1159/000171896

Cited by 2 publications

(2 citation statements)

References 4 publications

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“…There are numerous reports of bleeding liver cell adenomas during pregnancy and the puerperium, and women with known liver cell adenomas should be strongly advised not to become pregnant [3,[52][53][54][55][56][57][58][59]. Excision of a liver cell adenoma has been successfully performed during the second trimester [52].…”

Section: Complications and Management Of Solitary Liver Cell Adenomamentioning

confidence: 99%

Liver cell adenoma and liver cell adenomatosis

Barthelmes

Tait

2005

HPB

117

151

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During the last three decades liver cell adenoma and liver cell adenomatosis have emerged as new clinical entities in hepato-logical practice due to the widespread use of oral contraceptives and increased imaging of the liver. On review of published series there is evidence that 10% of liver cell adenomas progress to hepatocellular carcinoma, diagnosis is best made by open or laparoscopic excision biopsy, and the preferred treatment modality is resection of the liver cell adenoma to prevent bleeding and malignant transformation. In liver cell adenomatosis, the association with oral contraceptive use is not as high as in solitary liver cell adenomas. The risk of malignant transformation is not increased compared with solitary liver cell adenomas. Treatment consists of close monitoring and imaging, resection of superficially located, large (>4 cm) or growing liver cell adenomas. Liver transplantation is the last resort in case of substantive concern about malignant transformation or for large, painful adenomas in liver cell adenomatosis after treatment attempts by liver resection.

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Section: Complications and Management Of Solitary Liver Cell Adenomamentioning

confidence: 99%

Liver cell adenoma and liver cell adenomatosis

Barthelmes

Tait

2005

HPB

117

151

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“…Fifteen cases of HCA-associated hemorrhage were included, none occurred in the first trimester and all HCA measuring 6.5 cm. 33,34,36,43,44,46,49,52 Eight HCA bled during gestation, seven in the third trimester. The remaining seven bleeding cases occurred during labor (n = 2) or postpartum (n = 5).…”

Section: Discussionmentioning

confidence: 99%

Behavior and complications of hepatocellular adenoma during pregnancy and puerperium: a retrospective study and systematic review

Haring

Spijkerboer

Cuperus

et al. 2021

HPB

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Background: Hepatocellular adenomas (HCA) are benign liver tumors at risk of hemorrhage. The influence of pregnancy on HCA growth and potential bleeding remains unclear. This study investigates HCA-associated behavior and bleeding complications during or shortly after pregnancy. Methods: (I) Single center retrospective cohort study of HCA during and after pregnancy (II) Systematic literature review.Results: The retrospective study included 11 patients, of which 4 with HCA 5 cm. In only two patients HCA showed growth during pregnancy. In this local cohort, no HCA-related hemorrhages occurred during median follow-up of 34 months (interquartile range 19-58 months). The systematic review yielded 33 studies, totaling 90 patients with 99 pregnancies. Of 73 pregnancies without prior HCA-related intervention, 39 HCA remained stable (53.4%), 11 regressed (15.1%), and 23 (31.5%) progressed.Fifteen HCA-related hemorrhages occurred in HCA measuring 6.5-17.0 cm. Eight patients experienced bleeding during pregnancy, two during labor and five postpartum.Discussion: Although hemorrhage of HCA during or shortly after pregnancy is rare and only reported in HCA 6.5 cm, it can be fatal. Pregnancy in women with HCA, regardless of size, warrant a close surveillance strategy. Observational studies on behavior and management of HCA 5 cm during and immediately after pregnancy are needed.

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Hepatic Cell Adenoma: Spontaneous Rupture during Pregnancy

Abstract: Hepatic cell adenoma associated with oral contraceptives may grow and become more vascular during pregnancy, and is at risk of rupture. The case is reported of a lady presenting as an emergency with rupture of an adenoma, treated by local resection, in the 22nd week of pregnancy.

Cited by 2 publications

References 4 publications

Liver cell adenoma and liver cell adenomatosis

Liver cell adenoma and liver cell adenomatosis

Behavior and complications of hepatocellular adenoma during pregnancy and puerperium: a retrospective study and systematic review

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