Risk factors for bleeding hepatocellular adenoma in a United States cohort

Background & Aims Known risk factors for hepatocellular adenoma (HCA) bleeding are size >5 cm, growth rate, visible vascularity, exophytic lesions, β‐catenin and Sonic Hedgehog activated HCAs. Most studies are based on European cohorts. The objective of this study is to identify additional ri...

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Bibliographic Details
Published in:Liver international 2022-01, Vol.42 (1), p.224-232
Main Authors: McDermott, Chelsea, Ertreo, Marco, Jha, Reena, Ko, Jimin, Fernandez, Stephen, Desale, Sameer, Fishbein, Thomas, Satoskar, Rohit, Winslow, Emily, Smith, Coleman, Hsu, Christine C
Format: Article
Language:English
Subjects:
Adenoma
Adenoma, Liver Cell - complications
Adenoma, Liver Cell - diagnosis
Adenoma, Liver Cell - epidemiology
benign liver tumours
Bleeding
Carcinoma, Hepatocellular - epidemiology
Carcinoma, Hepatocellular - pathology
Fatty liver
Growth rate
haemorrhage
Hedgehog Proteins
hepatic adenomatosis
hepatic steatosis
hepatocellular adenomas
Humans
Hyperplasia
Lesions
Liver Neoplasms - pathology
Magnetic Resonance Imaging
Malignancy
non‐alcoholic fatty liver disease
Patients
Retrospective Studies
Risk analysis
Risk Factors
Statistical analysis
Steatosis
Tumors
United States - epidemiology
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Summary:Background & Aims Known risk factors for hepatocellular adenoma (HCA) bleeding are size >5 cm, growth rate, visible vascularity, exophytic lesions, β‐catenin and Sonic Hedgehog activated HCAs. Most studies are based on European cohorts. The objective of this study is to identify additional risk factors for HCA bleeding in a US cohort. Methods Retrospective chart review was performed on patients diagnosed with HCA on magnetic resonance imaging (n = 184) at an academic tertiary institution. Clinical, pathological, and imaging data were collected. Primary outcomes measured were HCA bleeding and malignancy. Statistical analysis was performed with SAS 9.4 using Chi‐Square, Fisher’s exact test, sample t test, non‐parametric Wilcoxon test, and logistic regression. Results After excluding patients whose pathology showed focal nodular hyperplasia and non‐adenoma lesions, follow‐up data were available for 167 patients. 16% experienced microscopic or macroscopic bleeding and 1.2% had malignancy. HCA size predicted bleeding (P 
ISSN:1478-3223
1478-3231
DOI:10.1111/liv.15087