Immunohistochemical Staining on an Excision Biopsy Specimen as a Diagnostic Modality for Rare Idiopathic Hepatocellular Adenoma: A Case Report

Juferdy Kurniawan, Andri Sanityoso, Toar JM Lalisang, Ening Krisnuhoni, Sahat Matondang, Abirianty P Araminta, Lutfie Lutfie

Abstract


Hepatocellular adenoma is an extremely rare benign tumor of the liver which predominantly in young women. Its rare incidence with estimated 3-4 cases per 1.000.000 annually makes it a diagnostic challenge. Here we present a 30-year-old female patient with hepatocellular adenoma without classic risk factors. A series of work up tools have been performed in order to diagnose the condition. None but excision biopsy from segmental resection had been showed to increase diagnostic confidence. This case illustrates the role of immunohistochemical staining from excision biopsy as the best diagnostic modality of hepatocellular adenoma as well as therapeutic modality to prevent malignant transformation.

Keywords


liver adenoma; benign liver tumor; diagnosis; immunohistochemical marker; resection

References


Chang CY, Hernandez-Prera JC, Roayaie S, Schwartz M, Thung SN. Changing epidemiology of hepatocellular adenoma in the United States: review of the literature. Int J Hepatol 2013. Article ID 604860. doi:10.1155/2013/604860.

Rooks JB, Ory HW, Ishak KG, et al. Epidemiology of hepatocellular adenoma: the role of oral contraceptive use. JAMA.1979;242(7):644-8.

Soe KL, Soe M, Gluud C. Liver pathology associated with the use of anabolic-androgenic steroids. Liver 1992;12:73.

Curry MP, Afdhal NH. Hepatic adenoma. In: Chopra, Sanjiv, eds. Up to date. Retrieved May 12, 2015, from http://www.uptodate.com/home.

Bioulac-Sage P, Balabaud C, Zucman-Rossi J. Subtype classification of hepatocellular adenoma. Dig Surg. 2010;27(1):39-45.

Van Aalten SM, Thomeer MG, Terkivatan T, et al. Hepatocellular adenomas: correlation of MR imaging findings with pathologic subtype classification. Radiology. 2011;261(1):172-81.

Geller S, Petrovic L. Benign tumors and tumor-like conditions. Biopsy Interpretation of the Liver. 3rd ed. Philadelphia: Williams and Wilkins, 2003. p. 281-304.

Kahn ME, French S, Wang HL. Hepatocellular adenoma: Morphological and molecular variants and distinction from well-differentiated hepatocellular carcinoma. Pathol Case Rev. 2009;14:13-20.

Palladino E, Sommacale D, Siboni R, et al. Focal nodular hyperplasia and hepatocellular adenomas: What is new in 2013? Int J Hepatobiliary Pancreat Dis. 2014;4:15-25.

Dhingra S. Update on the new classification of hepatic adenomas: Clinical, molecular, and pathologic characteristics. Arch Pathol Lab Med. 2014;138:1090-7.

Grazioli L, Federle MP, Brancatelli G, Ichikawa T, Olivetti L, Blachar A. Hepatic adenomas: imaging and pathologic findings. Radiographics. 2001;21:877-94.

Ichikawa T, Federie MP, Grazioli L, Nalesnik M. Hepatocellular adenoma: multiphasic CT and histopathologic findings in 25 patients. Radiology. 2000;214(3):861-8.

Charny CK, Jarnagin WR, Schwartz LH, et al. Management of 155 patients with benign liver tumors. Br J Surg. 2001;88:808-13.

Van der Windt DJ, Kok NF, Hussain SM, et al. Case-oriented approach to the management of hepatocellular adenoma. Br J Surg. 2006;93:1495-502.

Margolskee E, Bao F, Gonzalez AK, et al. Hepatocellular adenoma classification: a comparative evaluation of immuno-histochemistry and targeted mutational analysis. Diag Pathol. 2016;11:27.

Aalten SM, Vledder MG, Terkivatan T, Man RA, Leertouwer T, Ijzermans JN. Safety and efficacy of radiofrequency ablation for hepatocellular carcinoma. J Vasc Intervent Radiol. 2011;22(6):787-93.


Full Text: PDF

Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 Acta Medica Indonesiana