Hepatocellular adenoma:

It is an uncommon benign liver tumor which is associated with the use of hormonal contraception with a high estrogen content.  Patients taking hormones with prolonged duration have a significantly increased risk of developing hepatocellular carcinoma and 30% risk of bleeding.

About 25-50% of hepatic adenomas cause pain in the right upper quadrant or epigastria region of the abdomen. Since hepatic adenomas can be large (8–15 cm), patients may notice a palpable mass. However, hepatic adenomas are usually asymptomatic, and may be discoveredincidentally on imaging ordered for some unrelated reason

It is important to distinguish hepatic adenoma from other benign liver tumors, such as hemangiomas and focal nodular hyperplasia, because hepatic adenomas have a small but meaningful risk of progressing into a malignancy. CT scan  & MRI  are the useful test for diagnosing hepatic adenoma. Contraceptive pills or other steroids should be stopped. Removal of the tumor is the ideal treatment strategy

 

Hepatoblastoma : It is the most common liver tumour in children. It accounts for between 60 and 85% of all hepatic tumors in children. The incidence is twice as high in boys than girls. Key markers include elevation of alpha -fetoprotein  ( AFP). Hepatoblastoma occurs with a world-wide incidence of 0.5-1.5 cases per million children. The tumour progress  slowly in the liver and extrhepatic tissues through stage I to IV

Resection of the tumour (hepatectomy) is the gold standard treatment . Larege tumours can be downgraded by chemotherapy ( neoadjuvent) followed by resection.  Liver transplantation have been used to treat these neoplasms, which provide high, long term disease-free survival rate .Resection and adjuvant chemotherapy survival rates approach 100%.The presence of metastases is the most potent predictor of poor prognosis.


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