Background: Hepatocellular adenoma (HCA) is the second most common benign liver neoplasm and occurs predominantly in women in their reproductive years. Positron-emission tomography (PET) using [18F] fluorodeoxyglucose (FDG) is commonly used in cancer staging, surveillance and evaluation of the treatment response. PET-avid HCA is rare and can be falsely interpreted as malignancies.
Methods: A retrospective review of four institutions' database was performed to identify the PET-avid HCAs with clinico-pathological correlation.
Results: Nine patients with histological proven PET-avid HCA was identified. Eight out of nine patients were female with a median age at diagnosis of 44 years. All patients' tumours with available histological subtyping (8/8) were HNF1-α mutated and had no inflammatory changes; six out the nine lesions had prominent (>50%) steatotic changes.
Conclusion: Hepatocellular adenomas, specifically the HNF1-α subtype, can cause false-positive PET findings when seeking to identify malignancy. Concomitantly, PET-CT may have the potential to identify the HCA histopathological variant with the lowest malignant and haemorrhagic potential.
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Article Synopsis
- Hepatocellular adenoma is a rare, benign liver tumor mostly found in young women using hormonal contraceptives, particularly estrogen.
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- The case emphasizes the importance of considering hepatocellular adenoma in younger women on birth control who have severe abdominal pain, highlighting the need for awareness and proper management strategies for this condition.
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