title: Will weight loss become a future treatment of hepatocellular adenoma in obese patients?
abstract: OBJECTIVE
  Although hepatocellular adenoma (HCA) is more frequently observed in obese patients, however, the effect of weight loss as a therapeutic option was never studied.
  
  
  METHODS
  In this rapid communication we described our non-surgical management of large HCA (>5 cm) encountered in patients with morbid obesity. Non-surgical management consisted mainly of oral contraception withdrawal and weight loss, which was the only option in two patients. All demographics, radiological and histological data were studied. Patients were followed regularly every 6 months.
  
  
  RESULTS
  Between 2004 and 2013, 116 patients presented with HCA and 15 with morbid obesity (13%) were studied. Five men underwent surgery and females were either operated (period before 2010; n = 5) or proposed to non-surgical management (period after 2010; n = 5).Weight loss was advocated to all females, including four with residual HCA after resection and to non-operated patients, including two with haemorrhagic HCA. Four (40%) females showed significant weight loss. In resected patients, weight loss allowed stability (n = 1) or slight regression (n = 1) of residual HCA. In the two patients treated only by weight loss, significant decrease was observed in the weight with significant decrease (>50%) in the size and number of HCA to a non-surgical size (<5 cm). Severe morbidity was 40% in operated patients and 0% in non-operated patients. After a follow-up period of 38 months (18-60), no complication or degeneration was encountered in the non-operated group.
  
  
  CONCLUSIONS
  Like oral contraception, weight loss should be considered as the first therapeutic option in the management of HCA in obese patients.
authors.affiliation: Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Clichy, France.|Assistance Publique Hôpitaux de Paris, University Paris 7 Denis Diderot, Paris, France.
authors.forename: Safi
authors.initials: S
authors.lastname: Dokmak
authors.affiliation: Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Clichy, France.|Assistance Publique Hôpitaux de Paris, University Paris 7 Denis Diderot, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
mesh_terms: D018248:Adenoma, Liver Cell / Q000150:complications / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D019468:Disease Management; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D014057:Tomography, X-Ray Computed; D015431:Weight Loss; D055815:Young Adult
keywords: hepatocellular adenoma; obesity; regression; weight loss