Polymorphic multiple hepatocellular adeno-ma including a non-steatotic HNF1α-inacti-vated variant

摘要

To the Editor:Hepatocellular adenomas (HCAs) consist of benign liver tumors favored by the use of oral contraceptives, which preferentially occur in women.[1, 2] They expose to the risk of hemorrhage (20% of cases) and more rarely, to the risk of malignant transformation (4%-10% of cases).[3, 4] Multiple HCAs, which are defined by the presence of 10 or more HCAs, were first described in 1985 and were initially considered having a worse prognosis than single HCA.[5]However, recent reports have suggested that the risk of complications in patients with multiple HCAs was not related to the number of lesions, but mainly to three other factors: i) tumor size >5 cm for the risk of both hemorrhage and malignant transformation;[3] ii) male gender and iii) β-catenin-mutation for the risk of malignant transformation.[6] Progresses made in terms of genotypic knowledge of HCA have allowed to identify different subtypes of HCA associated with more specific risks of complication.[7]