title: Incidental inflammatory adenoma with β-catenin activation in the setting of paediatric NASH.
abstract: Hepatocellular adenomas (HCA) are benign tumours with potential for malignant transformation with no recommendations regarding management in the paediatric population. We report a case of an inflammatory adenoma with β-catenin activated pathway in an obese, paediatric patient with nonalcoholic steatohepatitis (NASH).
  
  
  
  An 11-year-old female presented with a microlobulated liver lesion measuring >5 cm in magnetic resonance imaging (MRI) with inflammatory adenoma with β-catenin activated pathology arising in a background of NASH, nonalcoholic fatty liver disease (NAFLD) activity score 5/8. Imaging follow-up demonstrated stable disease without progression for 3 years.
  
  
  
  Malignant transformation of Hepatocellular adenomas in a child is approximately 4.2%. It is unknown if hepatic steatosis increases this risk. Obese patients mainly develop inflammatory and β-catenin activated (highest risk for malignant transformation) adenomas. Our patient had inflammatory and β-catenin activation, which led to monitoring for malignant transformation.
  
  
  
  We report a β-catenin activated inflammatory adenoma in a child with obesity and NASH with ongoing expectant management.
authors: Division of Gastroenterology, Hepatology and Nutrition, Cincinnati, USA.
authors: S
authors: S
authors: Oliveira
authors: Division of Gastroenterology, Hepatology and Nutrition, Cincinnati, USA.
authors: A K
authors: AK
authors: Samba
authors: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
authors: A J
authors: AJ
authors: Towbin
authors: Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
authors: A
authors: A
authors: Gupta
authors: Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
authors: J I
authors: JI
authors: Geller
authors: Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.|Department of Surgery, University of Cincinnati, Cincinnati, USA.
authors: J D
authors: JD
authors: Nathan
authors: Division of Gastroenterology, Hepatology and Nutrition, Cincinnati, USA.
authors: R
authors: R
authors: Kohli
mesh_terms: D018248:Adenoma, Liver Cell / Q000150:complications* / Q000378:metabolism; D002471:Cell Transformation, Neoplastic; D002648:Child; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000378:metabolism / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications*; D063766:Pediatric Obesity / Q000150:complications*; D051176:beta Catenin / Q000378:metabolism*
chemical_list: C495270:CTNNB1 protein, human; D051176:beta Catenin
keywords: Child; fatty liver; hepatic neoplasm; obesity