What Is Hepatic Adenoma?

If your doctor tells you that have a hepatic adenoma, it means you have a liver tumor that is "benign." That's another way of saying that it isn't cancer. It won't spread to other parts of your body.

Hepatic adenoma is very rare. It happens more often in women, because it's linked to the use of birth control pills.

The tumor starts from liver cells called hepatocytes. You might also hear your doctor call it hepatocellular adenoma.

Symptoms

About half of the time, hepatic adenomas don't cause any symptoms. You may not even know that you have one. But some can cause pain or a lump in your stomach area. Or you may feel bloated or full for no reason.

The tumor can also bleed heavily or burst, which can cause symptoms like:

If you have any of these symptoms, get medical help right away. It's a life-threatening emergency.

Causes

Anyone can get a hepatic adenoma. Changes in your genes, called mutations, may play a role.

There are certain things that can raise your chances of getting it. Medicines and conditions that affect your sex hormones, such as estrogen and testosterone, may lead to a hepatic adenoma.

Birth control pills. Your odds of getting a hepatic adenoma go up when you take higher-dose estrogen pills for longer periods of time.

Pregnancy. When you're expecting, your body releases higher levels of sex hormones.

Anabolic steroids. These drugs act like testosterone.

Clomiphene. This fertility drug has an effect similar to estrogen.

Recombinant human growth hormones. They're used to treat growth disorders.

Other things that raise your chances of getting hepatic adenoma include:

Obesity and metabolic syndrome. Doctors have seen a link between these problems and hepatic adenoma, especially in men.

Type I and type III glycogen storage diseases. These genetic diseases can affect how your liver works.

Barbiturates. These sedatives are linked with hepatic adenoma.

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Diagnosis

If your doctor thinks you may have a liver tumor, you'll get an imaging test, such as an ultrasound.

If the scans show that you have a tumor, you'll likely get another imaging test that can show more detail, such as an MRI or a CT scan. This helps your doctor confirm that it's a hepatic adenoma.

In rare cases, your doctor may need more information about your tumor. You may need a biopsy. That's a procedure where a doctor removes a sample of your tissue and checks it under a microscope.

Types

There are four main kinds of hepatic adenoma. Each has different features, but they're usually treated the same way.

Inflammatory. These make up 40%-50% of cases, and they're usually found in women.

HNF-1 inactivated. This type accounts for 35%-40% of all hepatic adenomas. Mostly seen in women, HNF-1 inactivated adenomas usually don't have complications.

Beta-catenin activated. Men tend to get this kind of adenoma, which makes up 15%-20% of cases.

Unclassified. These are 10% of hepatic adenomas.

Complications

If you don't get treatment, the tumor can bleed heavily or burst. This is more common in larger tumors. Pregnant women, those who recently took hormones, and those with inflammatory hepatic adenomas have higher chances of getting these complications.

About 5% of the time, hepatic adenomas turn into liver cancer. This happens more often in men, as well as those with larger or beta-catenin activated tumors.

Treatment

If you're diagnosed with hepatic adenoma, your doctor will suggest that you stop taking any medicines with estrogen, such as birth control pills. This may cause your tumor to shrink. Your doctor will also encourage you to keep to a healthy weight.

Your doctor will also suggest treatment based on whether you're a man or a woman and the size of your tumor.

Men. Hepatic adenomas are more likely to turn into cancer in men. Because of this, doctors usually recommend that men have surgery to remove the tumor.

Women with small tumors and no symptoms. If your tumor is 5 centimeters or less, your doctor will suggest watching the tumor over time instead of treating it. You'll get an MRI after 6 months and then once a year to make sure the tumor isn't getting bigger.

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Women with small tumors and symptoms. Your doctor will likely suggest surgery.

Women with large tumors. If your tumor is more than 5 centimeters, your doctor will likely recommend surgery. If you stopped taking birth control pills, you may wait 6 months to see if the tumor shrinks.

If you can't or don't want to get surgery, your options include:

Transarterial embolization. In this procedure, a doctor blocks blood flow to your tumor.

Radiofrequency ablation. This treatment may be useful for tumors less than 3 centimeters that are causing pain. An electric current heats a small area of nerve tissue, which stops the pain.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on June 26, 2020

Sources

SOURCES:

American Cancer Society: "What is Liver Cancer?"

Cleveland Clinic: "Radiofrequency Ablation."

Hippokratia: "Management of a Giant Hepatocellular Adenoma. Report of a Case."

JAMA Surgery: "Hepatic Adenoma, Spontaneous Liver Rupture, and Oral Contraceptives."

National Cancer Institute: "Benign Tumor," "Biopsy," "Transarterial Embolization."

RadioGraphics: "Hepatic Adenomas: Imaging and Pathologic Findings."

Therapeutic Advances in Gastroenterology: "Hepatocellular Adenoma: When and How to Treat? Update of Current Evidence."

StatPearls: "Hepatic (Hepatocellular) Adenoma."

UpToDate: "Hepatocellular Adenoma."

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