Women with a hepatic adenoma measuring 5 cm or larger are first managed conservatively — cessation of exogenous hormones and weight loss — with active monitoring over 6–12 months. When the lesion does not regress below 5 cm, further intervention is required. This protocol addresses that next step.
Female patient with a hepatic cell adenoma 5 cm or larger. For females with hepatic adenomas of this size, modification of risk factors and a structured observation period are the initial approach — including cessation of oral contraceptive pills, hormonal intrauterine devices, and anabolic steroids, and a recommendation for weight loss where applicable.
The preceding step was cessation of exogenous hormone use (oral contraceptive pills, hormonal intrauterine devices, and anabolic steroids), and weight loss if applicable, with observation over 6–12 months. The goal of that step — regression of the hepatic adenoma to less than 5 cm — was not achieved. The adenoma has remained at 5 cm or larger, triggering escalation to this protocol.
When the adenoma persists at 5 cm or larger after the observation period, a definitive surgical approach is pursued to reduce the risk of serious complications. The complete operative details and protocol are available via the link below.
DOI: 10.14309/ajg.0000000000002857