Case Reports in Gastroenterology (Nov 2020)

Malignant Transformation of an HNF1a-Inactivated Hepatocellular Adenoma to Hepatocellular Carcinoma

  • Joris T. Hepkema,
  • Floris B. Poelmann,
  • Annette S.H. Gouw,
  • Robbert J. de Haas,
  • Evelien W. Duiker,
  • Hans Blokzijl,
  • Joost M. Klaase

DOI
https://doi.org/10.1159/000510215
Journal volume & issue
Vol. 14, no. 3
pp. 577 – 585

Abstract

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Hepatocellular adenomas (HCA) are rare benign tumors of the liver, occurring predominantly in females using oral contraceptives. Our case describes a 66-year-old woman presenting with a palpable mass in her upper abdomen. Contrast-enhanced computed tomography and magnetic resonance imaging showed a large exophytic mass protruding from the caudal border of liver segments IV and V, without visible metastases. Laparoscopic resection of the tumor and gallbladder was performed. Histopathological examination showed a hepatocellular carcinoma with areas of HNF1a-HCA (H-HCA). This case shows that malignant transformation is possible in H-HCA. We present our preoperative decision-making process, as well as the role of imaging techniques in this rare case.

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