Treatment of hepatic adenomatosis

Hepatic adenomatosis and hepatocellular adenomas share risk factors and the same pathophysiologic spectrum. The presence in the liver of 10 hepatocellular adenomas defines hepatic adenomatosis. The diagnosis may be established incidentally during a liver radiologic examination in the asymptomatic patient, or after associated right upper quadrant pain, hepatomegaly or liver test abnormalities. Upon the diagnosis of hepatic adenomatosis or either of its lifethreatening complications—hemorrhage and progression to hepatocellular carcinoma—consideration should be given to potential medical, radiologic, and surgical interventions including observation (estrogen and androgen withdrawal), resection, transarterial embolization, radiofrequency ablation, and liver transplantation. The management of patients with hepatic adenomatosis can be challenging. These patients should be ideally referred to centers with expertise in the management of liver diseases.