title: Liver adenomatosis: reappraisal, diagnosis, and surgical management: eight new cases and review of the literature.
abstract: OBJECTIVE
  Liver adenomatosis (LA) is a rare disease originally defined by Flejou et al in 1985 from a series of 13 cases. In 1998, 38 cases were available for analysis, including eight personal cases. The aim of this study was to review and reappraise the characteristics of this rare liver disease and to discuss diagnosis and therapeutic options.
  
  
  BACKGROUND
  LA was defined as the presence of >10 adenomas in an otherwise normal parenchyma. Neither female predominance nor a relation with estrogen/progesterone intake has been noted. Natural progression is poorly known.
  
  
  METHODS
  The clinical presentation, evolution, histologic characteristics, and therapeutic options and results were analyzed based on a personal series of eight new cases and an updated review of the literature.
  
  
  RESULTS
  From a diagnostic standpoint, two forms of liver adenomatosis with different presentations and evolution can be defined: a massive form and a multifocal form. The role of estrogen and progesterone is reevaluated. The risks of hemorrhage and malignant transformation are of major concern. In the authors' series, liver transplantation was indicated in two young women with the massive, aggressive form, and good results were obtained.
  
  
  CONCLUSIONS
  Liver adenomatosis is a rare disease, more common in women, where outcome and evolution vary and are exacerbated by estrogen intake. Most often, conservative surgery is indicated. Liver transplantation is indicated only in highly symptomatic and aggressive forms of the disease.
authors.affiliation: Department of Hepatobiliary Surgery, University Hospital of Caen, France.
authors.forename: L
authors.initials: L
authors.lastname: Chiche
authors.forename: T
authors.initials: T
authors.lastname: Dao
authors.forename: E
authors.initials: E
authors.lastname: Salamé
authors.forename: M P
authors.initials: MP
authors.lastname: Galais
authors.forename: N
authors.initials: N
authors.lastname: Bouvard
authors.forename: G
authors.initials: G
authors.lastname: Schmutz
authors.forename: P
authors.initials: P
authors.lastname: Rousselot
authors.forename: P
authors.initials: P
authors.lastname: Bioulac-Sage
authors.forename: P
authors.initials: P
authors.lastname: Ségol
authors.forename: M
authors.initials: M
authors.lastname: Gignoux
mesh_terms: D018248:Adenoma, Liver Cell / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome