When a benign liver tumor presents with radiologic features that raise concern for malignant change, the clinical approach shifts significantly regardless of lesion size.
Hepatic adenoma of any size in which imaging findings are concerning for malignant transformation. In this setting, the lesion is managed with the same level of urgency and intent as a primary liver malignancy.
Management follows the framework applied to hepatocellular carcinoma, with consideration of interventional and surgical strategies — the specific pathway and sequencing are detailed in the full protocol.
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.
Patients who are not candidates for surgical resection can be treated with other modalities used for HCC treatment including ablation, embolization, radiation therapy, and/or liver transplantation.
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