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Hepatocellular adenoma, also called hepatic adenoma, liver cell adenoma, or hepadenoma, is a benign, or noncancerous, tumor in the liver associated with the use of hormonal contraception with a high estrogen content. Hepatocellular adenoma is extremely rare, affecting less than two in every million people per year, and 90% of cases occur in women aged 20 to 40 who take oral contraceptives. If a hepatocellular adenoma is allowed to grow, it can rupture, causing massive bleeding in the liver. For this reason, and because they may have malignant or cancerous portions, all hepatocellular adenomas should be surgically removed.
Women over 30 who have taken oral contraceptives for over five years have the highest risk of developing a hepatocellular adenoma. People with glycogen storage diseases, both men and women, are also at risk, and men are twice as likely to develop the condition than women within this group. Patients may have only one tumor or many.
Hepatocellular adenoma can cause abdominal pain, as well as the more serious complications discussed above. There may also be a palpable mass in the abdomen, and in the case of hemorrhage, signs of shock including decreased and irregular heartbeat. In a pregnant woman, the condition can result in the death of the fetus or the mother.
Hepatocellular adenoma is usually diagnosed through magnetic resonance imaging (MRI) or a computed tomography (CT) scan. Surgical removal of the lesion is the best way to confirm diagnosis, and can prevent serious complications. A woman diagnosed with hepatocellular adenoma should immediately stop taking birth control, though she should also avoid pregnancy until the liver has been cleared of tumors. The cessation of birth control medication may cause the tumor to regress on its own, but the danger of malignancy still remains.
Surgical removal of hepatic adenoma may be done laparoscopically, through a small incision, if the tumor is small and on the surface of the liver. Most cases of hepatocellular adenoma can be addressed by removing only part of the liver. Liver transplant may be necessary in patients with widespread multiple tumors, or with a glycogen storage disease.
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