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World J Gastroenterol. Apr 14, 2022; 28(14): 1384-1393
Published online Apr 14, 2022. doi: 10.3748/wjg.v28.i14.1384
Hepatocellular adenoma: Where are we now?
Xi Wang, Xuchen Zhang
Xi Wang, Xuchen Zhang, Department of Pathology, Yale University School of Medicine, New Haven, CT 06520, United States
Author contributions: Wang X reviewed the literature and drafted the manuscript; Zhang X provided overall intellectual input, reviewed the literature, acquired the histological images, and edited the final version of the manuscript; all authors approved the final version to be published.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xuchen Zhang, MD, PhD, Associate Professor, Department of Pathology, Yale University School of Medicine, 310 Cedar Street, PO Box 208023, New Haven, CT 06520, United States. xuchen.zhang@yale.edu
Received: December 5, 2021
Peer-review started: December 5, 2021
First decision: January 8, 2022
Revised: January 9, 2022
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: April 14, 2022

Hepatocellular adenoma (HCA) is a benign hepatocellular neoplasm, commonly occurs in young women with a history of oral contraceptive use. Complications including hemorrhage and malignant transformation necessitate the need for a thorough understanding of the underlying molecular signatures in this entity. Recent molecular studies have significantly expanded our knowledge of HCAs. The well-developed phenotype-genotype classification system improves clinical management through identifying “high risk” subtype of HCAs. In this article, we attempt to provide updated information on clinical, pathologic and molecular features of each subtype of HCAs.

Keywords: Hepatocellular adenoma, Subtype, Pathology, Classification, Hepatocellular carcinoma

Core Tip: Hepatocellular adenoma (HCA) has been well recognized as a benign liver neoplasm with risks of hemorrhage and malignant transformation. Studies revealed that different HCA subtypes with specific genetic mutation and pathologic findings are associated with different clinical features. Currently HCAs are classified into at least 5 major subtypes, involving 4 different pathways driving HCA pathogenesis: Hepatocyte nuclear factor 1A, interleukin-6/the Janus kinase/signal transducer and activator of transcription, β-catenin, and Sonic hedgehog pathway.