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Clinical features and natural history of hepatocellular adenomas: the impact of obesity.
MedLine Citation:
PMID:  21762186     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background  Hepatocellular adenoma is a benign tumour associated with bleeding and malignant transformation. Obesity has been linked to hepatic tumourigenesis. Aim  To evaluate the presentation of hepatocellular adenoma in obesity, and the impact of obesity on the clinical course. Methods  Records of 60 consecutive patients (between 2005 and 2010) with a diagnosis of hepatocellular adenoma from a single tertiary centre were analysed. Results  Fifty six of 60 patients were women, median age was 36 years, 75% had history of contraceptive use, 18% were overweight and 55% were obese (BMI ≥30 kg/m(2) ). Majority (63%) were asymptomatic; seven patients presented with bleeding. Single (28%) and multiple adenomas (72%) were encountered; size ranged from 1 to 19.7 cm. Obesity was more often associated with multiple adenomas (85% vs. 48%, P = 0.005), bilobar distribution (67% vs. 33%, P = 0.01), lower serum albumin (P = 0.007) and co-morbidities of fatty liver (P = 0.006), diabetes (P = 0.003), hypertension (P = 0.006) and dyslipidemia (P = 0.03). During median follow-up of 2.6 years, there were no instances of bleeding, malignant transformation or death. Thirty four patients underwent therapeutic intervention (17 surgical resection, nine transarterial embolization and eight both interventions sequentially). The rate of complete resection of adenoma(s) was significantly lower in obese patients (8% vs. 69%, P = 0.004). In the 26 patients without intervention, tumour size progression was more frequently observed in obese patients (33% vs. 0%, P = 0.05). Three of 15 obese patients (20%) lost ≥5% body weight and there was no progression in the liver lesions. Conclusions  Obesity and features of metabolic syndrome were frequently observed in hepatocellular adenoma. Multiple and bilobar adenomas were more frequent in obese patients. Among patients who were conservatively managed, tumour progression was more often associated with obesity.
Authors:
C Bunchorntavakul; R Bahirwani; D Drazek; M C Soulen; E S Siegelman; E E Furth; K Olthoff; A Shaked; K R Reddy
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-15
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  -     ISSN:  1365-2036     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Division of Gastroenterology and Hepatology and Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA. Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA. Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
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