title: [Extracapsular hepatic adenoma. Case report and literature review].
abstract: BACKGROUND
  Hepatic adenomas are uncommon epithelial tumours. They usually appear in women between 20 and 44 years old. They are commonly located in the right hepatic lobe and are typically solitary masses. Multiple adenomas can present in patients with prolonged use of oral contraceptive pills, glycogen storage diseases and hepatic adenomatosis.
  
  
  METHODS
  A 35 year-old woman without any significant past medical history, with a chief complaint that started in December 2012 with oppressive, mild intensity abdominal pain located in right upper quadrant in the abdomen on deep palpation. With an abdominal ultrasound showing a mass of 91×82×65cm located in the right flank, isoechogenic with internal vascularity. Contrast computed tomography scan showing an ovoid tumour with circumscribed borders, with heterogenic intense reinforcement and displacement of adjacent structures with dimensions of 88×71×80cm. In laparotomy, excision of the tumour and cholecystectomy with the trans surgical findings of an 8cm tumour with a pedicle containing one artery and one vein coming from the hepatic free border with strong adhesions to the gallbladder. Pathologic diagnosis: Extracapsular hepatic adenoma.
  
  
  CONCLUSIONS
  Incidence of hepatic adenomas has increased in the last decades, in a parallel fashion with the introduction of oral contraceptive pills, showing association with glycogen storage diseases and to a lesser degree with diabetes and pregnancy. Diagnosis is clinical with the aid of imaging studies. Prognosis of hepatic adenomas is not well established, therefore, management depends on symptoms, size, number, location and certainty of diagnosis.
authors.affiliation: Departamento de Cirugía General, Hospital de Especialidades, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México. Electronic address: eddgar868@gmail.com.
authors.forename: Edgar
authors.initials: E
authors.lastname: Vargas-Flores
authors.affiliation: Departamento de Cirugía General, Hospital General Regional 25, Instituto Mexicano del Seguro Social, Ciudad de México, México.
authors.forename: Francisco
authors.initials: F
authors.lastname: Pérez-Aguilar
authors.affiliation: Departamento de Anatomía Patológica, Hospital General Regional 25, Instituto Mexicano del Seguro Social, Ciudad de México, México.
authors.forename: Yanet
authors.initials: Y
authors.lastname: Valdez-Mendieta
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery
keywords: Adenoma hepático; Adenomatosis hepática; Hepatic adenoma; Hepatic adenomatosis; Hepatic tumour; Tumor hepático