Malignant Transformation of an HNF1a-Inactivated Hepatocellular Adenoma to Hepatocellular Carcinoma

• Main Authors: Joris T. Hepkema, Floris B. Poelmann, Annette S.H. Gouw, Robbert J. de Haas, Evelien W. Duiker, Hans Blokzijl, Joost M. Klaase
• Format: Article
• Language: English
• Published: Karger Publishers 2020-11-01
• Series: Case Reports in Gastroenterology
• Subjects: hepatocellular adenoma; hepatocellular carcinoma; hepatocyte nuclear factor 1-alpha; imaging; surgical resection; laparoscopy
• Online Access: https://www.karger.com/Article/FullText/510215

Hepatocellular adenomas (HCA) are rare benign tumors of the liver, occurring predominantly in females using oral contraceptives. Our case describes a 66-year-old woman presenting with a palpable mass in her upper abdomen. Contrast-enhanced computed tomography and magnetic resonance imaging showed a large exophytic mass protruding from the caudal border of liver segments IV and V, without visible metastases. Laparoscopic resection of the tumor and gallbladder was performed. Histopathological examination showed a hepatocellular carcinoma with areas of HNF1a-HCA (H-HCA). This case shows that malignant transformation is possible in H-HCA. We present our preoperative decision-making process, as well as the role of imaging techniques in this rare case.