Hepatic adenoma is a benign liver tumor that, under certain circumstances, may develop imaging characteristics raising concern for malignant change. When this occurs, the clinical approach changes substantially — regardless of lesion size.
This protocol addresses hepatic adenoma of any size when imaging demonstrates features concerning for malignant transformation. The presence of such features — independent of lesion dimensions — defines this subset and drives a distinct, more aggressive management strategy.
When malignant transformation is suspected on imaging, the adenoma is managed with the same intent applied to hepatocellular carcinoma. Surgical resection is a primary consideration in this setting.
The full structured regimen — including the complete range of options, decision criteria, and clinical sequencing — is available via the protocol link below.
DOI: 10.14309/ajg.0000000000002857
Hepatic adenomas of any size that have imaging features concerning for malignant transformation should be treated as an HCC, with consideration to surgical resection, locoregional therapies, and/or liver transplantation.
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