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Current Approaches in the Management of Hepatic Adenomas.

Publication ,  Journal Article
Tsilimigras, DI; Rahnemai-Azar, AA; Ntanasis-Stathopoulos, I; Gavriatopoulou, M; Moris, D; Spartalis, E; Cloyd, JM; Weber, SM; Pawlik, TM
Published in: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
January 2019

Hepatic adenomas (HAs) are a benign and relatively rare type of liver neoplasms. We review the diagnosis, evaluation, and potential therapeutic management options for patients with HA.A comprehensive review of the English literature was performed utilizing MEDLINE/PubMed and Web of Science databases with end of search date the 30th April of 2018. In PubMed, the terms "hepatocellular," "hepatic," "liver," and "adenoma," "adenomatosis" were searched in the title and/or abstract.Recent advances in molecular classification of HA have determined distinct subtypes with specific clinical, pathological, and imaging characteristics. In general, cessation of exogenous hormonal administration or weight loss may lead to HA regression. Surgical resection, either open or laparoscopic, should be considered in patients with symptoms and risk factors for hemorrhage or malignant transformation. These risk factors include tumor diameter greater than 5 cm, β-catenin activated subtype, and/or male gender. The management of acute hemorrhage should primarily aim at achieving hemodynamic stability via angioembolization followed by elective resection, whereas malignant transformation is treated according to oncologic resection principles. Although pregnancy is one of the known risk factors for tumor growth and associated complications, the presence of an HA per se should not be considered a contradiction to pregnancy.Future genomic-based multicenter studies are required to provide a strong basis for formulating an evidence-based risk-adapted model that guides individualized management strategies for patients with HA.

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Published In

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

DOI

EISSN

1873-4626

ISSN

1091-255X

Publication Date

January 2019

Volume

23

Issue

1

Start / End Page

199 / 209

Related Subject Headings

  • Tumor Burden
  • Surgery
  • Sex Factors
  • Liver Transplantation
  • Liver Neoplasms
  • Humans
  • Hepatectomy
  • Hemorrhage
  • Embolization, Therapeutic
  • Conservative Treatment
 

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Tsilimigras, D. I., Rahnemai-Azar, A. A., Ntanasis-Stathopoulos, I., Gavriatopoulou, M., Moris, D., Spartalis, E., … Pawlik, T. M. (2019). Current Approaches in the Management of Hepatic Adenomas. Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, 23(1), 199–209. https://doi.org/10.1007/s11605-018-3917-4
Tsilimigras, Diamantis I., Amir A. Rahnemai-Azar, Ioannis Ntanasis-Stathopoulos, Maria Gavriatopoulou, Demetrios Moris, Eleftherios Spartalis, Jordan M. Cloyd, Sharon M. Weber, and Timothy M. Pawlik. “Current Approaches in the Management of Hepatic Adenomas.Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract 23, no. 1 (January 2019): 199–209. https://doi.org/10.1007/s11605-018-3917-4.
Tsilimigras DI, Rahnemai-Azar AA, Ntanasis-Stathopoulos I, Gavriatopoulou M, Moris D, Spartalis E, et al. Current Approaches in the Management of Hepatic Adenomas. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 2019 Jan;23(1):199–209.
Tsilimigras, Diamantis I., et al. “Current Approaches in the Management of Hepatic Adenomas.Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, vol. 23, no. 1, Jan. 2019, pp. 199–209. Epmc, doi:10.1007/s11605-018-3917-4.
Tsilimigras DI, Rahnemai-Azar AA, Ntanasis-Stathopoulos I, Gavriatopoulou M, Moris D, Spartalis E, Cloyd JM, Weber SM, Pawlik TM. Current Approaches in the Management of Hepatic Adenomas. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 2019 Jan;23(1):199–209.
Journal cover image

Published In

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

DOI

EISSN

1873-4626

ISSN

1091-255X

Publication Date

January 2019

Volume

23

Issue

1

Start / End Page

199 / 209

Related Subject Headings

  • Tumor Burden
  • Surgery
  • Sex Factors
  • Liver Transplantation
  • Liver Neoplasms
  • Humans
  • Hepatectomy
  • Hemorrhage
  • Embolization, Therapeutic
  • Conservative Treatment