What is hepatic adenoma?

The causative factors of hepatic adenoma are not very clear at present. It is known to be closely related to oral contraceptives, so most of the patients are young women. The most prominent feature of hepatic adenoma is pain in the right upper abdomen, accompanied by nausea. Some patients with hepatic adenoma do not even have obvious symptoms. Regardless of whether they have symptoms or not, they need treatment as soon as possible. A comprehensive understanding of the disease is important. Let's take a look at what hepatic adenoma is.

Etiology: The real cause of this disease is unknown. It is now believed that its occurrence is closely related to oral contraceptives: more than 90% of hepatic adenoma patients occur in young women, and at least 75% of patients have a history of taking contraceptives. Women over 30 years old who take contraceptives have an increased risk of the disease; the incidence of hepatic adenoma is directly related to the time and dosage of taking contraceptives; hepatic adenoma rarely occurs in postmenopausal women, and hepatic adenoma occurring in men may be related to diabetes, glycogen storage disease and the use of androgen. Clinical manifestations vary with tumor size, location, and the presence or absence of complications. 5% to 10% have no symptoms and are discovered accidentally during physical examination or surgery. About 1/3 of patients with hepatic adenoma have abdominal masses and recent right upper abdominal pain, which may be dull in nature, accompanied by nausea, poor appetite and other discomforts. However, when the tumor ruptures and bleeds, the patient may experience sudden severe pain in the right upper abdomen. Physical examination may reveal tense abdominal muscles, local tenderness and rebound pain, and in severe cases, there may be manifestations of hemorrhagic shock. Jaundice and fever are occasionally seen. Clinicians should pay attention to the fact that HCA not only has a tendency to rupture and bleed, but also has the potential to transform into hepatocellular carcinoma.

1. Abdominal mass type: This type is more common. Patients often have no symptoms except for a mass in the upper abdomen. A tumor can be felt during physical examination. Its surface is smooth, hard, and usually non-tender. The mass moves up and down with breathing. If it is a cystadenoma, it may feel cystic when palpated. When the tumor gradually grows larger and compresses adjacent organs, symptoms such as upper abdominal distension, discomfort, nausea, and dull pain may appear.

2. Acute abdomen adenoma is supplied by a single artery, which is generally not supported by connective tissue. Intratumoral bleeding often occurs, sometimes leading to capsule rupture. When intratumoral bleeding occurs, the patient may have sudden right upper abdominal pain, accompanied by nausea, vomiting, fever, etc. During physical examination, there may be tension, tenderness and rebound pain in the right upper abdominal muscles. It is often misdiagnosed as acute cholecystitis and surgery is performed. During the operation, hepatic adenoma is discovered. The tumor ruptures and causes intra-abdominal bleeding. The patient may experience severe pain in the right upper abdomen, abdominal tenderness and rebound pain and other peritoneal irritation symptoms. In severe cases, shock may occur due to excessive bleeding.

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