Hepatocellular Carcinoma Arising in an HNF-1α–Mutated Adenoma in a 23-Year-Old Woman with Maturity-Onset Diabetes of the Young: A Case Report

Stueck, Ashley; Qu, Zhenhong; Huang, Mike; Campreciós, Genís; Ferrell, Linda D.; Thung, Swan N.

doi:10.1055/s-0035-1567827

Cited by 21 publications

(12 citation statements)

References 20 publications

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“…Finally, according to the recent literature, H-HCA almost never degenerate into HCC, although some very rare cases have been reported [ Stueck et al 2015 ]. The low risk of H-HCA degeneration may help to simplify the management of liver adenomas as will be discussed later.…”

Section: Reviewing the Known Complicationsmentioning

confidence: 99%

Hepatocellular adenoma: when and how to treat? Update of current evidence

Thomeer

Bröker

Verheij

et al. 2016

Therap Adv Gastroenterol

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Hepatocellular adenoma (HCA) is a rare, benign liver tumor. Discovery of this tumor is usually as an incidental finding, correlated with the use of oral contraceptives, or pregnancy. Treatment options have focused on conservative management for the straightforward, smaller lesions (<5 cm), with resection preferred for larger lesions (>5 cm) that pose a greater risk of hemorrhage or malignant progression. In recent years, a new molecular subclassification of HCA has been proposed, associated with characteristic morphological features and loss or increased expression of immunohistochemical markers. This subclassification could possibly provide considerable benefits in terms of patient stratification, and the selection of treatment options. In this review we discuss the decision-making processes and associated risk analyses that should be made based on lesion size, and subtype. The usefulness of this subclassification system in terms of the procedures instigated as part of the diagnostic work-up of a suspected HCA will be outlined, and suitable treatment schemes proposed.

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Section: Reviewing the Known Complicationsmentioning

confidence: 99%

Hepatocellular adenoma: when and how to treat? Update of current evidence

Thomeer

Bröker

Verheij

et al. 2016

Therap Adv Gastroenterol

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“…Because HHCAs showed the lower risk of malignant transformation, typical features of small H-HCAs at MRI in young women could avoid biopsy and lead to radiologic follow-up [ 36 , 63 ]. It should be emphasized that HCC can arise also in these lesion, as recently reported [ 64 ]. In the absence of typical features of H-HCA at MRI, a tumor biopsy should be proposed to search for β-catenin activation/mutation and to better assess the risk of malignant transformation [ 33 , 36 , 43 ].…”

Section: Hepatocellular Adenoma (Hca)mentioning

confidence: 54%

Benign hepatocellular nodules of healthy liver: focal nodular hyperplasia and hepatocellular adenoma

2016

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Owing to the progress of imaging techniques, benign hepatocellular nodules are increasingly discovered in the clinical practice. This group of lesions mostly arises in the context of a putatively normal healthy liver and includes either pseudotumoral and tumoral nodules. Focal nodular hyperplasia and hepatocellular adenoma are prototypical examples of these two categories of nodules. In this review we aim to report the main pathological criteria of differential diagnosis between focal nodular hyperplasia and hepatocellular adenoma, which mainly rests upon morphological and phenotypical features. We also emphasize that for a correct diagnosis the clinical context such as sex, age, assumption of oral contraceptives, associated metabolic or vascular disturbances is of paramount importance. While focal nodular hyperplasia is a single entity epidemiologically more frequent than adenoma, the latter is representative of a more heterogeneous group which has been recently and extensively characterized from a clinical, morphological, phenotypical and molecular profile. The use of the liver biopsy in addition to imaging and the clinical context are important diagnostic tools of these lesions. In this review we will survey their systematic pathobiology and propose a diagnostic algorithm helpful to increase the diagnostic accuracy of not dedicated liver pathologists. The differential diagnosis between so-called typical and atypical adenoma and well differentiated hepatocellular carcinoma will also be discussed.

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“…For the molecular changes and tumor biomarkers of HCC, the authors found that by immunohistochemical tests, CD34 expression in sinusoidal endothelial cells and expression of glutamine synthetase in tumor cells were increased, whereas exon 3 of CTNNB1 and TERT promoter mutations, and nuclear expression of β-catenin were absent in this patients with HCC and DM. Although such cases are rare, they reinforce the potential of H-HCA for HCC, which may be related to DM[ 98 ].…”

Section: Mpe In Dm and Risk Of Hccmentioning

confidence: 99%

“…One case report which was published in 2015 was also considered to be related to this field[ 98 ]. This report describes a 23-year-old woman with HCC and type 2 DM; and results of histological and immunohistochemical examination showed that this HCC arose in the background of hepatocyte nuclear factor-1α mutated hepatocellular adenomas (H-HCA).…”

Section: Mpe In Dm and Risk Of Hccmentioning

confidence: 99%

Molecular pathological epidemiology in diabetes mellitus and risk of hepatocellular carcinoma

Gao

2016

WJH

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Molecular pathological epidemiology (MPE) is a multidisciplinary and transdisciplinary study field, which has emerged as an integrated approach of molecular pathology and epidemiology, and investigates the relationship between exogenous and endogenous exposure factors, tumor molecular signatures, and tumor initiation, progression, and response to treatment. Molecular epidemiology broadly encompasses MPE and conventional-type molecular epidemiology. Hepatocellular carcinoma (HCC) is the third most common cause of cancer-associated death worldwide and remains as a major public health challenge. Over the past few decades, a number of epidemiological studies have demonstrated that diabetes mellitus (DM) is an established independent risk factor for HCC. However, how DM affects the occurrence and development of HCC remains as yet unclearly understood. MPE may be a promising approach to investigate the molecular mechanisms of carcinogenesis of DM in HCC, and provide some useful insights for this pathological process, although a few challenges must be overcome. This review highlights the recent advances in this field, including: (1) introduction of MPE; (2) HCC, risk factors, and DM as an established independent risk factor for HCC; (3) molecular pathology, molecular epidemiology, and MPE in DM and HCC; and (4) MPE studies in DM and risk of HCC. More MPE studies are expected to be performed in future and I believe that this field can provide some very important insights on the molecular mechanisms, diagnosis, personalized prevention and treatment for DM and risk of HCC.

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Hepatocellular Carcinoma Arising in an HNF-1α–Mutated Adenoma in a 23-Year-Old Woman with Maturity-Onset Diabetes of the Young: A Case Report

Cited by 21 publications

References 20 publications

Hepatocellular adenoma: when and how to treat? Update of current evidence

Hepatocellular adenoma: when and how to treat? Update of current evidence

Benign hepatocellular nodules of healthy liver: focal nodular hyperplasia and hepatocellular adenoma

Molecular pathological epidemiology in diabetes mellitus and risk of hepatocellular carcinoma

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