Treatment of Liver Cell Adenoma During Pregnancy

Clinical scenario

Hepatic adenoma (HCA) diagnosed or monitored in a pregnant patient. In the setting of pregnancy, HCAs may exhibit growth and progression, raising the risk of serious complications.

When intervention is indicated

Hepatic adenomas should be monitored regularly throughout pregnancy. Intervention becomes necessary when an adenoma grows to greater than 6.5 cm or when high-risk features for hemorrhagic rupture are identified — the approach taken depends on gestational age.

The complete protocol specifies the interventions, criteria for each, and the timing considerations across gestational age.

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References

DOI: 10.14309/ajg.0000000000002857

In the setting of pregnancy, HCAs may exhibit growth and progression.

Hepatic adenomas should be monitored regularly during pregnancy and should be treated if there is growth to .6.5 cm or with high-risk features for hemorrhagic rupture.

Adenomas that exhibit growth during pregnancy particularly to .6.5 cm in size or have high-risk features for hemorrhagic rupture including exophytic lesions should be treated with resection if early in the pregnancy or embolization before 26 weeks' gestation.

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