[Diagnosis and treatment of hepatocellular adenoma in the Netherlands: national agreement is desired].
The recommendation of Van der Windt et al. in this issue that the diagnosis 'hepatocellular adenoma' can be made only on the basis of imaging studies should be applied with caution. Tissue diagnosis remains the gold standard. Although the real risk of malignant degeneration of hepatocellular adenoma remains unknown, there is agreement that preventive excision is indicated when the size is > 5 cm. In case of bleeding from a hepatocellular adenoma, selective embolisation of the proper hepatic artery is effective. Secondary resection of the adenoma following bleeding is not always necessary. The withdrawal of oral contraceptives is the first recommendation after a diagnosis of hepatocellular adenoma is made, which is often followed by regression of the tumour. The elective embolisation of a hepatocellular adenoma via the hepatic artery is a new, promising form of treatment that can lead to regression. The recommendations made in the article constitute a good point of departure for a national discussion.
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Heelkunde, Postbus 22.660, 1100 DD Amsterdam. t.m.vangulik@amc.uva.nl
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D018248:Adenoma, Liver Cell / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy; D001707:Biopsy, Needle; D003276:Contraceptives, Oral / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy; D016896:Treatment Outcome
D003276:Contraceptives, Oral