This protocol addresses a specific clinical scenario: a female patient with a liver cell adenoma (hepatic adenoma) measuring less than 5 cm. This size threshold and patient sex are central to the management approach.
Asymptomatic hepatic adenomas smaller than 5 cm in women can generally be monitored and initially managed conservatively, provided imaging does not raise concern for higher-risk molecular subtypes. Modification of contributing factors is a key component of the approach in this group.
For patients who are not candidates for resection, locoregional therapy is among the options to be considered. The full protocol details the criteria, sequencing, and specific modalities involved.
DOI: 10.14309/ajg.0000000000002857
Females with asymptomatic HCAs diagnosed at <5 cm in size can be monitored and initially managed conservatively unless imaging prompts concerns for b-catenin mutated subtype.
In women with hepatic adenomas <5 cm, we suggest discontinuation of exogenous hormones and advise weight loss, if applicable, for overweight or obese individuals (conditional recommendation, very low level of evidence).
If the patient is not a candidate for resection, then locoregional therapy should be considered.
In patients with hepatic adenomas requiring treatment who are unable to undergo surgical resection, we suggest embolization or ablation as alternative treatment approaches (conditional recommendation, low level of evidence).
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