title: PET-avid hepatocellular adenomas: incidental findings associated with HNF1-α mutated lesions.
abstract: BACKGROUND
  Hepatocellular adenoma (HCA) is the second most common benign liver neoplasm and occurs predominantly in women in their reproductive years. Positron emission tomography (PET) using [18F] fluorodeoxyglucose (FDG) is commonly used in cancer staging, surveillance and evaluation of treatment response. PET-avid HCA are rare and can be falsely interpreted as malignancies.
  
  
  METHODS
  A retrospective review of four institutions' database was performed to identify the PET-avid HCAs with clinico-pathological correlation.
  
  
  RESULTS
  Nine patients with histological proven PET-avid HCA was identified. Eight out of 9 patients were female with a median age at diagnosis of 44 years. All patients' tumors with available histological subtyping (8/8) were HNF1-α mutated and had no inflammatory changes; 6 out the 9 lesions had prominent (>50%) steatotic changes.
  
  
  CONCLUSIONS
  Hepatocellular adenomas, specifically the HNF1-α subtype, can cause false-positive PET findings when seeking to identify malignancy. Concomitantly, PET-CT may have the potential to identify the HCA histopathologic variant with the lowest malignant and hemorrhagic potential.
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.
authors.forename: Ser Yee
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States.
authors.forename: T Peter
authors.initials: TP
authors.lastname: Kingham
authors.affiliation: New York-Presbyterian Hospital - Weill Cornell Medical Center, Diagnostic Radiology, 1305 York Avenue, New York, NY 10021, United States.
authors.forename: Maria D
authors.initials: MD
authors.lastname: LaGratta
authors.affiliation: New York Presbyterian Hospital - Weill Cornell Medical College, Surgical Pathology, 525 East 68th Street, New York, NY 10065, United States.
authors.forename: Jose
authors.initials: J
authors.lastname: Jessurun
authors.affiliation: Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Cherqui
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States.
authors.forename: William R
authors.initials: WR
authors.lastname: Jarnagin
authors.affiliation: New York Presbyterian Hospital Columbia Presbyterian Medical Center, Department of Surgery, 161 Fort Washington Avenue 823, New York, NY 10024, United States. Electronic address: mk2462@cumc.columbia.edu.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Kluger
mesh_terms: D018248:Adenoma, Liver Cell / Q000000981:diagnostic imaging* / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D000328:Adult; D014408:Biomarkers, Tumor / Q000235:genetics*; D001706:Biopsy; D004252:DNA Mutational Analysis; D016208:Databases, Factual; D003951:Diagnostic Errors; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D051538:Hepatocyte Nuclear Factor 1-alpha / Q000235:genetics*; D006801:Humans; D033162:Incidental Findings; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D008297:Male; D009154:Mutation; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; C496487:HNF1A protein, human; D051538:Hepatocyte Nuclear Factor 1-alpha; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18