1. Hepatocellular adenoma
Chapter 13
Hepatic Tumors, Benign 1
Hepatocellular adenoma
Case 13.1

2. Clinical Presentation13
Hepatic Tumors, Benign 2
Clinical Presentation
A 30-year-old woman was admitted for evaluation of right upper quadrant pain that at times was severe.
She had a 25 lb weight loss from a diet (“Weight Watchers”) and had been on oral contraceptives for the past 12 years.

3. Laboratory Values Course in Hospital LDH: 365 (NI 52-149) AST: 3513
Hepatic Tumors, Benign 3
Laboratory Values
LDH: 365 (NI )
α-Fetoprotein: 5.0 (normal range)
HBsAg: Negative
AST: 35
ALT: 22
Alk Phos: 101
Course in Hospital
Further workup led to an exploratory laparotomy revealing a large mass in the right hepatic lobe that was resected.

4. Pathology 13 4 Hepatic Tumors, Benign
The tumor measured 13 × 6 × 5 cm and was multilobulated and gray-tan with focal areas of hemorrhage.
The entire tumor was composed of cytologically benign hepatocytes forming trabecular cords one to two cells thick (a, b).
Figure 13.1(a)

5. 13
Hepatic Tumors, Benign 5
Pathology
Figure 13.2(b)

6. 13
Hepatic Tumors, Benign 6
Diagnosis
Hepatocellular adenoma

7. 13
Hepatic Tumors, Benign 7
Comment
Although no genotyping was performed, this tumor best fits the hepatocyte nuclear factor 1α (HNF1α)-inactivated variant of hepatocellular adenomas, although usually that variant has some degree of steatosis as well (see Chapter 13, Table 13.2, Genotypic and phenotypic classification of hepatocellular adenomas).
Importantly, although complications such as abdominal pain, tumor necrosis, and tumor rupture may still occur, malignant transformation is not a feature of this subtype.