Liver adenoma types and treatment

As a rule, liver adenoma is diagnosed accidentally during other examinations. The insidiousness of this disease is almost asymptomatic – the first signs can appear only after a spontaneous rupture of the tumor.

In most cases, liver adenoma develops as a complication of rare hereditary diseases or as a result of long-term hormone intake.

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Differential diagnostics

Hepatocellular adenoma is a hormone-dependent benign tumor, most often a single one.

Risk factors for neoplasm development include:

  • long-term use of oral contraceptives,
  • long-term use of anabolic steroids,
  • type I glycogenosis (Gierke’s disease),
  • type III glycogenosis (Corey-Forbes disease).

In the diagnosis, it is important to differentiate oncology from other focal liver lesions. In 70–80% of cases, this is a single tumor with clear boundaries, relatively large (5–15 cm), localized subcapsularly in the right lobe of the liver. In patients with type I glycogenosis, adenomatosis sometimes develops – the simultaneous presence of more than 5 tumor foci.

Tumor types

In total, there are 4 subtypes of liver adenoma:

  • Inflammatory hepatocellular adenoma.

The most common type with the highest risk of bleeding.

  • Adenomatosis with mutated nuclear factor 1 alpha (HNF 1-a).

The second most common species, often with multiple nodes.

  • Beta-catenin mutated hepatic adenoma (b-HCA).

This species is the least common (10-15%). Such a tumor occurs in men taking anabolic steroids or as a result of hereditary diseases.

  • Unclassified liver adenoma.

In 10% of cases, these are neoplasms without identified genetic abnormalities.

Only a doctor can accurately determine the type of tumor, focusing on the results of examinations.

Symptoms

In most cases, the disease is completely asymptomatic and is found by chance, while diagnosing symptoms or treating other liver diseases. Signs of adenoma of the liver in women and the first symptoms may be hormonal changes in the blood, especially high levels of estrogen.

Symptoms of a ruptured liver adenoma:

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  • dizziness, fainting,
  • arterial hypotension,
  • cold sweat, thirst,
  • pallor, shock,
  • unbearable sharp pain in the abdomen.

Women taking oral contraceptives should ask their doctor about the possible consequences of taking these drugs.

What is dangerous disease

There is a certain risk that large neoplasms can become malignant with the degeneration of liver tissue into hepatocellular carcinoma.

Liver adenoma is dangerous because it can rupture into the abdominal cavity. The rupture of the tumor is accompanied by severe internal bleeding. Tumor ruptures occur in 30% of cases, of which about 9% are fatal. As a rule, death is associated with late seeking medical help.

Necessary tests and examinations

To study the state of internal organs and differentiate the tumor, ultrasound examination (ultrasound) of the liver is used. In addition, the doctor can send a general and biochemical blood test, hormone examination, which can show hormonal disruptions.

Then they are sent for CT or MRI for a more complete visualization of the neoplasm.

Diagnosing the problem

To identify the causes of the development of the pathology, a complete anamnesis is collected (including family), a number of examinations are carried out to select the treatment for liver adenoma.

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The main method for diagnosing a neoplasm is an ultrasound examination, in which the pathology can be well examined, the size of the neoplasm can be determined, and it is preliminarily classified.

To study the characteristics of the blood supply to the liver adenoma, CT or MRI diagnostics are used. Previously, angiography was used for this, but now its appointment is not justified.

As a rule, this type of tumor is not prone to malignancy, but the final malignant nature of the degeneration can only be determined by the results of biopsy of the neoplasm tissues.

Choosing a method of treatment

The most effective treatment is surgery with complete removal of the tumor under general anesthesia. The operation is performed to eliminate the risk of spontaneous rupture and to finally confirm the diagnosis with a biopsy of the tumor tissue. During the period of preparation for the operation, the patient is registered in order to undergo the necessary examinations before surgery.

In cases where the lesion is small and the neoplasm has not encapsulated, it is advisable to prescribe conservative therapy. The attending physician will prescribe which drugs will need to be taken and which should be discarded. First of all, this is the cessation of the use of hormonal drugs: oral contraceptives, steroids, anabolic steroids.

Prognoses

With planned treatment, the prognosis is generally positive. The postoperative period proceeds without any peculiarities. In some patients, fibromatous post-traumatic cysts of a benign nature may form, which do not require specific treatment.

Innovative diagnostic and treatment methods

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Previously, it was believed that ultrasound alone was not enough for accurate recognition of a tumor, but now there are more modern devices with the possibility of color Doppler examination.

Doppler can reveal the main blood supply to the tumor and the location of the internal and peripheral vessels. These data make it possible to supplement the visualization of the neoplasm using CT and MRI, more accurately select the required treatment method and predict the consequences.

Also recently, methods have been developed for minimally invasive tumor removal with minimal tissue damage.

ethnoscience

There are various recipes for treating the liver with folk remedies. One of the most effective herbs is considered to be milk thistle, which is used even in official medicine.

Traditional medicine can act as additional support for the liver during treatment, but it is impossible in principle to cure cancer with herbs. A neoplasm, especially if tissue encapsulation has already occurred, will not be able to dissolve under the influence of natural preparations.

Moreover, delay in treatment poses a serious risk of tumor rupture and severe internal bleeding, sometimes fatal.

Prevention

Hepatic adenoma was first discussed after 1960, when hormonal contraceptives were widely used. Women who take them for more than 5 years in a row fall into a special risk group.

Recent studies show that the risk of developing this type of tumor in women who do not take oral contraceptives is only 1 in 1,3 million, while after using them, the risk rises to 3,4 in 100 thousand. So far, there is no clear data on the risks of taking steroids and anabolic steroids, but the dependence is clear.

The main prevention of liver adenoma is a healthy lifestyle, refusal to use oral contraceptives and anabolic steroids. For people who are at risk, it is recommended that an ultrasound examination of the liver be performed annually. Recent studies show that low-carb foods and diets for liver adenomas can significantly speed up treatment and prevent tumor formation.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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