Repeat surgery in HNF1alpha-inactivated adenomatosis - 25/07/19
, Christophe Laurent b, Nora Frulio c, Saint Paul Marie Christine d, Brigitte Le Bail a, e, Laurent Possenti f, Jean Frédéric Blanc a, f, Laurence Chiche b, Paulette Bioulac-Sage aBienvenue sur EM-consulte, la référence des professionnels de santé.
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| pages | 8 |
| Iconographies | 2 |
| Vidéos | 0 |
| Autres | 0 |
Highlights |
• | Stopping oral contraceptives following nodule detection usually prevents further hepatocellular adenoma (HCA) growth. |
• | Rare cases of HCA growth have been reported leading eventually to a second intervention. |
• | Growth is only observed in rare HNF1 alpha-inactivated adenomatosis. |
• | Size of nodules may increase, probably in part through coalescence of micro-H-HCAs. |
• | A second intervention due to HCA expansion has to be evaluated; liver transplantation is still not an option. |
Summary |
Background and aims |
Stopping oral contraceptives following nodule detection usually prevents further hepatocellular growth (HCA); rare cases of growth have been reported after surgery. The aim of the study was to review our resected HCA cases and their outcomes and more specifically, growth.
Methods |
We retrieved all HCA cases that required a second intervention and HCA growth cases of none resected HCA after resection of one or several HCAs.
Results |
Out of the 210 resected classified HCA cases, a second resection was performed in 5 cases, 4 of which were in women with HNF1alpha-inactivated adenomatosis (H-adenomatosis) and had a favorable outcome. The fifth case was the occurrence of an inflammatory HCA, 3 years after resection of a previous one. Of the 65 resected HNF1-inactivated HCAs (H-HCAs), the nodules that remained continued to increase very slowly in 3 adenomatosis cases. After surgery, the liver became dysmorphic years later in one case, and the nodules grew but not significantly in another case. After the diagnosis of adenomatosis, progressive growth leads to surgery 12 years later in the last case.
Conclusion |
These results confirm that, in rare H-adenomatosis, size of nodules may increase very slowly, probably in part through coalescence of micro H-HCAs and leading occasionally to a second resection.
Le texte complet de cet article est disponible en PDF.Keywords : Hepatocellular adenoma, HNF1alpha-inactivated hepatocellular adenoma, Adenomatosis, Liver surgery
Plan
Vol 43 - N° 4
P. 460-467 - août 2019 Retour au numéro
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