Copyright ©The Author(s) 2020.
World J Gastroenterol. May 21, 2020; 26(19): 2294-2304
Published online May 21, 2020. doi: 10.3748/wjg.v26.i19.2294
Table 1 Clinicopathologic characteristics of different hepatocellular adenoma subtypes
HCA subtypeRisk factorsSpecific clinical featuresHistologic featuresIHCs
HHCAHNF1A germline mutations, MODY type 3, microsatellite instabilityHepatic adenomatosisIntralesional steatosisLFABP (absent/decreased)
IHCAObesity, alcohol, glycogenosisInflammatory syndromeSinusoidal dilatation, inflammatory infiltrateCRP, SAA
bex3HCAMale, liver vascular disease, androgen therapyFrequent malignant transformationPseudoacinar formation, mild nuclear atypiabeta-catenin (nuclear staining), GS (diffuse and strong)
bex7,8HCANo specific risk factorsNo specific clinical featuresNo specific featuresGS (weak, heterogeneous)
shHCAObesitySymptomatic bleedingIntratumoural hemorrhageProstaglandin D2 synthase
UHCANo specific risk factorsNo specific clinical featuresNo specific featuresNone
Table 2 Various clinical associations of pediatric hepatocellular adenomas
Sex hormone dysregulation
Oral contraceptive use
Klinefelter’s syndrome
Polycystic ovary syndrome
Sex hormone producing tumours (e.g., ertoli-Leydig cell tumours)
Androgen therapy (Turner’s syndrome, Fanconi anemia, Glanzmann's thrombasthenia)
Antiepileptic therapies with sodium ion channel modulation
Metabolic disorders
Glycogen storage diseases type I, III, and IV
Hurler syndrome (mucopolysaccharidosis type 1)
Fanconi Anemia (with or without androgen therapy)
Diabetes mellitus type II
Congenital portosystemic shunts
Cardiac hepatopathy (status-post Fontan procedure)
Other syndromes
Alagille syndrome
Familial adenomatous polyposis syndrome
Maturity-onset diabetes of the young type 3
McCune-Albright syndrome
Noonan syndrome with multiple lentigines
Prader Willi syndrome
Wolf-Hirschhorn syndrome