Malignant transformation of hepatocellular adenoma

Julien, Céline; Bail, Brigitte Le; Chiche, Laurence; Balabaud, Charles; Bioulac‐Sage, Paulette

doi:10.1016/j.jhepr.2022.100430

Cited by 5 publications

(8 citation statements)

References 11 publications

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“…A recent study of malignancy in HCA cases reported a surprisingly high frequency of malignant transformation of IHCA without β‐catenin mutation 66 . However, these findings could not be replicated by another recent study 67 …”

Section: Hca Classificationmentioning

confidence: 79%

“…However, the evaluation is biased, owing to the inclusion of only surgical samples. In addition, the presence of an HCA in an HCC, or a history of incomplete resection of an HCA, is a prerequisite for the diagnosis of HCA‐derived HCC; therefore, the precise frequency of pre‐existing HCA behind a fully developed HCC in a non‐cirrhotic liver is unknown 67,81 …”

Section: Hca Complicationsmentioning

confidence: 99%

“…In b‐HCA and b‐IHCA, the second molecular event leading to HCC has been shown to be a telomerase reverse transcriptase gene ( TERT ) promoter mutation, 84 whereas, in the other HCA subtypes, the pathway leading to malignant transformation is still unknown. Another unsolved issue is the prognosis of HCA‐derived HCCs, which are mostly well differentiated 67 . A recent study showed better long‐term survival for these patients than for those with non‐HCA‐derived HCC in non‐cirrhotic livers 66 .…”

Section: Hca Complicationsmentioning

confidence: 99%

“…In addition, the presence of an HCA in an HCC, or a history of incomplete resection of an HCA, is a prerequisite for the diagnosis of HCA-derived HCC; therefore, the precise frequency of pre-existing HCA behind a fully developed HCC in a non-cirrhotic liver is unknown. 67,81 The reported risk factors for malignant transformation of HCA are male sex, size (>50 mm), CTNNB1 mutation, in particular in exon 3, and concurrent liver diseases, particularly glycogen storage disorders (GSDs) and VLD. 78 The higher risk of NT malignant transformation in male patients has been well recognised since the work by Dokmak, who showed a 10-fold higher risk in men than in women, 6 leading to the recommendation in clinical guidelines to remove or ablate any HCA in men.…”

Section: A L I G N a N T T R A N S F O R M A T I O Nmentioning

confidence: 99%

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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: Hca Classificationmentioning

confidence: 79%

Section: Hca Complicationsmentioning

confidence: 99%

Section: Hca Complicationsmentioning

confidence: 99%

Section: A L I G N a N T T R A N S F O R M A T I O Nmentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2022

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“…We are honored to receive the pertinent and relevant comments of Céline Julien et al. , 1 and we enjoyed reading about the Bordeaux group’s experience with malignant transformation of hepatocellular adenoma (HCA). We are pleased to address the issues they raised regarding our study, which concerns a matched case-control study comparing the long-term outcome after liver resection for HCA with malignant transformation (MT-HCA) to hepatocellular carcinoma (HCC) developed on normal liver-parenchyma.…”

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confidence: 99%

Reply to: “Malignant transformation of hepatocellular adenoma”

et al. 2022

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Practical approach to diagnose and manage benign liver masses

Reguram,

Ghonge,

Tse

et al. 2024

Hepatology Communications

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Benign liver lesions are among the most commonly diagnosed abnormalities in liver imaging. They are often discovered incidentally during routine examinations or imaging conducted for unrelated reasons. These can be solid lesions, such as hemangiomas, focal nodular hyperplasia, hepatic adenomas, or cystic lesions. Recent advancements in MRI technology, particularly with hepatocyte-specific contrast agents, have enhanced the characterization of these lesions, reducing the reliance on invasive tissue sampling. Nevertheless, tissue sampling retains a crucial role in the evaluation of indeterminate lesions or those with malignant potential. While most benign liver lesions are asymptomatic, some can become symptomatic, causing discomfort, pain, or bleeding, particularly if the lesion is large. A deep understanding of the molecular underpinnings of the lesions is crucial for tailoring patient management strategies, particularly in distinguishing lesions that require surgical intervention from those that can be monitored. For instance, the molecular subclassification of hepatic adenomas has provided mechanistic insights and identified certain subtypes that are at higher risk of malignancy. Most benign liver lesions can be safely monitored; however, in patients with cirrhosis or a known primary malignancy, a high index of suspicion for cancer is required. It is crucial to carefully evaluate any liver lesion identified in these patients to ensure that indeterminate lesions are not overlooked. Effective management of benign liver lesions involves a multidisciplinary team, including hepatologists, surgeons, and radiologists, ensuring a comprehensive and individualized approach to patient care. This review outlines the clinical presentation of common benign liver lesions, providing a diagnostic and management framework. Emphasis is placed on a personalized approach to minimize patient distress and optimize outcomes by leveraging imaging advancements and multidisciplinary collaboration.

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Malignant transformation of hepatocellular adenoma

Cited by 5 publications

References 11 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

Reply to: “Malignant transformation of hepatocellular adenoma”

Practical approach to diagnose and manage benign liver masses

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