This page covers the first-line management approach for a female patient with confirmed liver cell adenoma (hepatocellular adenoma) in whom an activated beta-catenin mutation has not been demonstrated.
The patient is a woman diagnosed with hepatocellular adenoma. An activated beta-catenin mutation is not proven, which is a key factor in determining the appropriate management pathway.
The clinical target is an adenoma measuring less than 5 cm, stable or reduced in size, at reassessment after 6 months of management.
For women with hepatocellular adenoma and no proven activated beta-catenin mutation, the recommended first-line approach centres on lifestyle modification.
DOI: 10.1016/j.jhep.2016.04.001
In women, lifestyle change is recommended and should include the discontinuation of OCPs and control of body weight.
Upon HCA diagnosis, lifestyle changes such as discontinuation of OCP as well as weight loss should be advised (evidence level II-2, grade of recommendation 1).
In women, a period of 6 months observation after lifestyle change is advised and resection is indicated for nodules equal or greater than 5 cm and those continuing to grow (evidence level II-3, grade of recommendation 2).
For all presumed HCA, a reassessment with CE-MRI is advised after 6 months.