Liver adenomatosis: re-evaluation of aetiology and management.
BACKGROUND
Liver adenomatosis (LA) is a rare benign parenchymal liver disease with unknown aetiology. In recent reports, LA has been associated with hepatic steatosis, with potential implications for the management of this disease. The aim of this study was to determine prognosis and optimal management of patients with LA.


METHODS
Clinical presentation, diagnostic studies and management of patients with LA were analysed in our centre. Furthermore, a Medline search of all published case reports and series of LA patients was performed.


RESULTS
Ninety-four patients with LA have been reported in the literature. Fifty-two per cent of females had a history of oral contraceptive use. Eighteen per cent of patients had steatosis in nontumoral tissue. In our own series, five of six patients had histologically confirmed steatosis. Forty-three per cent of patients presented with acute pain, of whom 46% had a haemorrhagical complication, in contrast to 2% of nonsymptomatic patients. Tumours <5 cm tended to increase in size during follow-up and only in four patients tumour regression was observed.


CONCLUSIONS
Liver adenomatosis is a progressive, benign parenchymal disease mainly occurring in females. There is a potential link with hepatic steatosis with implications for the management of patients with LA. Noninvasive diagnosis is difficult because of the variety of tumoral and nontumoral components. Management should primarily be conservative.
Veteläinen
Reeta
R
Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Erdogan
Deha
D
de Graaf
Wilmar
W
ten Kate
Fiebo
F
Jansen
Peter L M
PL
Gouma
Dirk J
DJ
van Gulik
Thomas M
TM
D018248:Adenoma, Liver Cell / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D001707:Biopsy, Needle; D015331:Cohort Studies; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler