Two cases of hepatocellular adenomatosis treated with transcatheter arterial embolization

Abstract

Hepatocellular adenoma is a rare benign tumor of the liver. However, some complications, such as hemorrhage, rupture, and malignant transformation, have been reported previously. Surgical resection is considered to be the best choice of treatment, when adenomas are increasing in size, while resection is difficult to perform when multiple adenomas develop throughout the liver. Here, we report two cases of multiple hepatocellular adenomatosis. One patient had a history of aplastic anemia and the other had glycogen storage disease. We treated them with transcatheter arterial embolization (TAE) to prevent hemorrhage and rupture. After TAE, most parts of the adenomas showed necrotic change. These cases suggest that TAE is an effective treatment of hepatocellular adenomatosis.

Systematic review of transarterial embolization for hepatocellular adenomas

“…Seven cohort studies scored ‘yes’ on all 11 items of the CASP tool. All case reports were considered as level 4 evidence.…”

“…With a median follow‐up time of 12 months, no malignant transformation was reported, although five case reports did not provide information on this event. The type of embolization material was given in ten reports and included gelatin foam (4) (combined with lyophilized dura mater, lipiodol, lipodox, cephazolin or embolization coils), spongel, platinum coils, polyvinyl alcohol particles, glue, gelatin sponge and microspheres (Table S3, supporting information).…”

Management of Liver Adenomatosis by Radiofrequency Ablation

“…The low costs are due to low procedural costs, the relatively low complication rate and the absence of a long follow-up period for patients with no residual tumor [17]. Transcatheter arterial embolization followed by RFA could be an alternative and effective treatment strategy for LA to prevent rupture and hemorrhage in large tumors when it is difficult to perform a hepatectomy [19]. …”

Can a decision‐making model be justified in the management of hepatocellular adenoma?

“…Furthermore, in small tumours, RFA is the preferred treatment because of the short hospital stay, low cost and the best gain in QALYs as we mentioned earlier (67). A case report published in 2009 suggested elective treatment of multiple HCA with TAE to prevent rupture and bleeding (79). Regarding the risk of malignant degeneration (80), Barthelmes reviewed 17 patients of liver transplantation for LA.…”