title: The malignant transformation of liver cell adenomas.
abstract: OBJECTIVE
  To investigate clinical experience with the apparent malignant transformation of benign liver cell adenomas.
  
  
  METHODS
  Retrospective review of personal experience and literature.
  
  
  METHODS
  University hospital and affilated community hospitals.
  
  
  METHODS
  All patients diagnosed with liver cell adenomas over a 30-year period.
  
  
  METHODS
  Liver resection and/or tumor biopsy.
  
  
  METHODS
  Gender, age, drug associations, alpha-fetoprotein levels, response to treatment, and survival.
  
  
  RESULTS
  Thirteen patients from personal experience and 26 patients from the reports of others had liver cell adenomas that were not resected. Five of these patients subsequently developed hepatocellular carcinoma.
  
  
  CONCLUSIONS
  Malignant transformation of a liver cell adenoma is a rare phenomenon, but it does occur. Alpha-fetoprotein levels may be more helpful in diagnosis than expected from previous reports. Solitary benign adenomas should be resected whenever possible. Patients with diffuse multiple tumors should be observed closely over a long period.
authors.affiliation: Department of Surgery, University of Connecticut Health Center, Farmington.
authors.forename: J H
authors.initials: JH
authors.lastname: Foster
authors.forename: M M
authors.initials: MM
authors.lastname: Berman
mesh_terms: D000236:Adenoma / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D000328:Adult; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D002471:Cell Transformation, Neoplastic; D003131:Combined Modality Therapy; D003276:Contraceptives, Oral / Q000009:adverse effects; D004966:Estrogens, Conjugated (USP) / Q000009:adverse effects; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D003276:Contraceptives, Oral; D004966:Estrogens, Conjugated (USP); D013256:Steroids; D000509:alpha-Fetoproteins