Frederick C. Cobey, M.D., M.P.H., Ronald R. Salem, M.D. The American Journal of Surgery 187 (2004) 181-191.

Slides:

Advertisements

Similar presentations

Hepatic Adenoma – Can we do more? Joint Hospital Grand Round

Advertisements

Breast Cancer in Pregnancy

III. SLOVAK SURGICAL CONGRESS XXXIII. JOINT CONGRESS OF SLOVAK AND CZECH SURGEONS XXX. REIMAN’S DAYS SEPTEMBER , 2002 PREGNANT WOMEN IN CAR HAVE.

TEMPLATE DESIGN © MATERNAL OUTCOME OF EARLY VERSUS LATE TERMINATION OF PREGNANCY AMONG PREGNANT MOTHERS WITH PRENATAL.

Breena Holmes, MD MCH Director. Objectives Understand the context of maternal depression, nationally and locally and become familiar with Vermont improvement.

New-onset Diabetes is a Marker of Pancreatic Cancer Suresh T. Chari, MD Professor of Medicine Miles and Fitterman Center for Digestive Disease Mayo Clinic.

Biliary Cystadenoma and other complicated cystic lesions of the liver: Diagnostic and therapeutic challenges Teoh AYB Division of HBP Surgery Department.

Hepatic Adenoma 2005.Incidence of HCC in adenomas-8 to 14% “The surgeon is tempted to operate. However in most uncomplicated cases of adenoma it.

62 years old man Main complaint: Back pain at night but not during the day Loss of appettite Weight loss.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 5 The Liver Part I: Abdominal Sonography Abdomen and Superficial Structures.

Is a CT scan always necessary? A retrospective study looking at the diagnostic utility of US, CT and MRI imaging for liver lesions. Karthik Penumetsa,

Ayman Abdo MD, AmBIM, FRCPC

UTERINE FIBROIDS Hazem Al-Mandeel, M.D Course 481 Obstetrics and Gynecology Rotation.

NYU Medicine Grand Rounds Clinical Vignette Jay Desai, MD PGY3 January 19, 2011 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.

IDIOPATHIC ADULT COLO- COLIC INTUSSUSCEPTION

Cholestatic liver diseases:

Case Report Patient PP Submitted by:Matthew Clower, MSIV Faculty:Sandra Oldham, MD Date:29 August 2007 Radiological Category:Principal Modality (1): Principal.

 Determining the Nature of a Breast Abnormality  It is a procedure that may be used to determine whether a lump is a cyst (sac containing fluid) or a.

Introduction Oesophageal duplication cysts are rare congenital oesophageal anomalies in adults and are mostly asymptomatic. Diagnosis of an oesophageal.

Endometriosis in Caesarean section scar. A Case series. Introduction Scar endometriosis is a relatively rare gynaecological condition that is usually associated.

Hamid Tavakkoli, MD Associate Prof. of Gastroenterology.

Blatchford score is a useful tool for predicting the need for intervention in cancer patients with upper gastrointestinal bleeding. Ahn S, Lim KS, Lee.

Targeting HER2 and Focusing on Patients With Gastric Cancer Jose Maria Vieitez, MD, PhD Assistant Professor of Oncology Department of Medical Oncology.

Sidney M. Wolfe M.D and Sherri Shubin M.D., M.P.H. Public Citizen’s Health Research Group FDA Drug Safety and Risk Management and Dermatologic and Ophthalmic.

Obstructive Jaundice: A rare cause. A-65-year-old male. Three weeks of jaundice. Upper abdominal pain.

A 4 year old girl presenting with short stature Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

Student SYB Chet Cunha MS IV January 22, History 61 y/o M with known HCV x 5 yrs. presenting with vague abdominal discomfort. Outside CT showed.

Incidence and prognosis of hepatocellular adenoma in Denmark Lars Bossen Departments of Hepatology and Gastroenterology and Clinical Epidemiology Aarhus.

Diabetes in pregnancy Timing and Mode of Delivery

Preoperative Biliary Drainage for Cancer of the Head of the Pancreas Niels A. van der Gaag, M.D., Erik A.J. Rauws, M.D., Ph.D., Casper H.J. van Eijck,

Clinical History Patient presents with a palpable upper abdominal mass Patient states possible clinical history of abdominal hernia.

ANTENATAL CARE OF DIABETES IN PREGNANCY: AUDIT Rachael Read ST2 O&G Supervisor: Mr E Njiforfut Consultant.

ACUTE APPENDICITIS IN PREGNANCY : HOW TO MANAGE? HAMRI.A, AARAB.M,NARJIS.Y, RABBANI.K, LOUZI.A,BENELKHAIAT.R, FINECH.B SERVICE DE CHIRURGIE DIGESTIVE MARRAKECH.

BREAST BRACHYTHERAPY OUTCOMES EVALUATION Margaret Pierce DNP, APRN, BC University of Tennessee Knoxville, Tennessee.

Gangrenous Sigmoid Volvulus Complicating Pregnancy : Report Of A Case HAMRI.A, NARJIS.Y, RABBANI.K, LOUZI.A, BENELKHAIAT.R, FINECH.B SERVICE DE CHIRURGIE.

Hamid Tavakkoli, MD Associate Prof. of Gastroenterology.

Treatment Strategy for Recurrent Hepatocellular Carcinoma: Salvage Transplantation, Repeated Resection, or Radiofrequency Ablation? Albert C. Y. Chan,

Imaging of Focal Nodular Hyperplasia: A Review

Date of download: 6/20/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Evaluation of Benign vs Malignant Hepatic Lesions.

Thomas Sersté1,2, Vincent Barrau3, Violaine Ozenne1, Marie Pierre Vullierme3, Pierre Bedossa5,6, Olivier Farges4, Dominique-Charles Valla1,6, Valérie Vilgrain3,6,

Michael J. Campbell, MD Virginia Mason Medical Center Seattle, Washington.

Liver mass Mazen Hassanain. Radiology Arterial enhancement: adenoma, FNH, hemangioma, HCC, NET mets Portal enhancement: CRC liver mets.

Combined Embolization/Ablation of RCC in a Solitary Kidney

Differential Diagnosis

Hepatocellular Carcinoma: Diagnosis and Management

Focal nodular hyperplasia

Nodules & Tumors Nodular Hyperplasia non-cirrhotic liver nodules

Ovarian cysts and neoplasms in infant , children and adolescents

Endoscopic Removal of an Eroded Surgical Pledget

Treatment of Oligometatic PNET Mets to Liver Following Resection

Imaging Modalities for Focal Nodular Hyperplasia and Hepatocellular Adenoma Dig Surg 2010;27:46–55 - DOI: / © 2010 S. Karger AG, Basel.

HEPATIC RESECTION FOR PARENCHIMATOUS OVARIAN CANCER LIVER METASTASES BEYOND SECONDARY CYTOREDUCTION FOR RELPASED OVARIAN CANCER Nicolae Bacalbasa1,

Pancreatic Cancer What you need to know to be able to educate your patients and their families.

Chapter 13 Hepatic Tumors, Benign 1

Liver Masses: A Clinical, Radiologic, and Pathologic Perspective

Oren Shaked, Evan S. Siegelman, Kim Olthoff, K. Rajender Reddy

Volume 139, Issue 6, Pages (December 2010)

Jayant A. Talwalkar, MD, MPH, Patrick S. Kamath, MD

Hepatocellular adenoma

Biliary Stricture and Negative Cytology: What Next?

Banke Agarwal, Olivia J. Ludwig, Brian T. Collins, Cherise Cortese

Case of the Month: November 2018

Volume 65, Issue 2, Pages (August 2016)

Patrick Hoversten, Fouad Otaki, David A. Katzka

Desmoid-type fibromatosis Update on management guidelines

Adnexal masses 5 cm in diameter or greater extirpated during cesarean operation Serenat Eris Yalcin1, Yakup Yalcin2, Mehmet Ozgur Akkurt1, And Yavuz1,

Racial Differences in Survival of Hepatocellular Carcinoma in the United States: A Population-Based Study Jessica A. Davila, Hashem B. El–Serag Clinical.

Reversion of disease manifestations after HCV eradication

Presentation transcript:

Frederick C. Cobey, M.D., M.P.H., Ronald R. Salem, M.D. The American Journal of Surgery 187 (2004)

◦ Literature Review  Medline search from 1966 to 2002  keywords:  Hepatic mass  Pregnancy  Adenoma  Focal nodular hyperplasia  Hemangioma  26 pregnancies with liver cell adenomas were identified ◦ 7 additional illustrative cases of liver masses during pregnancy from the Department of Surgery of The Yale University School of Medicine  1 pregnancy with liver cell adenoma

 Aggressive approach to resection of LCA >5 cm should be seriously considered in pregnancy.  Small asymptomatic LCAs (<5 cm) may be observed during the course of pregnancy and may not require immediate surgical intervention  For smaller lesions early in pregnancy an aggressive approach to resections is suggested if an increase of the size is observed

Johanna E. Noels, Susanna M. van Aalten, Dirk J. van der Windt, Niels F.M. Kok, Rob A. de Man, Turkan Terkivatan, Jan N.M. Ijzermans Jounal of Hepatology 2010

 Between January 2000 and December 2009 The Erasmus Medical Center recorded all data of patients with LCA  Those patients were advised to discontinue the use of oral contraceptive and prevent pregnancy  11 patients got pregnant nevertheless and were closely monitored by ultrasound and/or MR imaging. (In 1 patient LCA was diagnosed during pregnancy)

 Presentation before pregnancy: ◦ 4 patients were symptomatic (pain right flank) ◦ 5 patients had unspecific complaints (abdominal pain) ◦ 2 patients were asymptomatic  Adenoma size at time of diagnosis: ◦ 7 patients: <5 cm ◦ 5 patients: >5 cm  These 12 patients were monitored during a total of 17 pregnancies

 Growth: ◦ In 4 pregnancies: Growth ◦ In 11 pregnancies: No growth/regression observed ◦ In 1 pregnancy: Minimal regression ◦ In 1 pregnancy: unknown  Interventions during pregnancy: ◦ 3 Cesarian sections, 1 radiofrequency ablation  All pregnancies had an uneventful course with a successful maternal and fetal outcome

 Pregnancy may be allowed to women with small tumors (<5 cm). Yet, close monitoring is proposed.  In women who have large tumors or who have experienced complications of LCA in previous pregnancies, a negative advice against pregnancy is justified because of an increased risk of complications. ◦ In that case, surgical resection should be recommended before pregnancy.

From: Management of Hepatocellular Adenoma: Recent Advances Shefali Agrawal, Sheela Agarwal, Thomas Arnason, Sanjay Saini, Jacques Belghiti Clinical Gastroenterology and Hepatology 2015;13: