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Hepatocellular adenoma in men: A nationwide assessment of pathology and correlation with clinical course.

Authors :
van Rosmalen, Belle V.
Furumaya, Alicia
Klompenhouwer, Anne J.
Tushuizen, Maarten E.
Braat, Andries E.
Reinten, Roy J.
Ligthart, Marjolein A. P.
Haring, Martijn P. D.
de Meijer, Vincent E.
van Voorthuizen, Theo
Takkenberg, R. Bart
Dejong, Cornelis H. C.
de Man, Robert A.
IJzermans, Jan N. M.
Doukas, Michail
van Gulik, Thomas M.
Verheij, Joanne
Source :
Liver International; Oct2021, Vol. 41 Issue 10, p2474-2484, 11p, 2 Diagrams, 3 Charts, 1 Graph
Publication Year :
2021

Abstract

Background & Aims: Hepatocellular adenomas (HCA) rarely occur in males, and if so, are frequently associated with malignant transformation. Guidelines are based on small numbers of patients and advise resection of HCA in male patients, irrespective of size or subtype. This nationwide retrospective cohort study is the largest series of HCA in men correlating (immuno)histopathological and molecular findings with the clinical course. Methods: Dutch male patients with available histological slides with a (differential) diagnosis of HCA between 2000 and 2017 were identified through the Dutch Pathology Registry (PALGA). Histopathology and immunohistochemistry according to international guidelines were revised by two expert hepatopathologists. Next generation sequencing (NGS) was performed to confirm hepatocellular carcinoma (HCC) and/or subtype HCA. Final pathological diagnosis was correlated with recurrence, metastasis and death. Results: A total of 66 patients from 26 centres fulfilling the inclusion criteria with a mean (±SD) age of 45.0 ± 21.6 years were included. The diagnosis was changed after expert revision and NGS in 33 of the 66 patients (50%). After a median follow‐up of 9.6 years, tumour‐related mortality of patients with accessible clinical data was 1/18 (5.6%) in HCA, 5/14 (35.7%) in uncertain HCA/HCC and 4/9 (44.4%) in the HCC groups (P =.031). Four B‐catenin mutated HCA were identified using NGS, which were not yet identified by immunohistochemistry and expert revision. Conclusions: Expert revision with relevant immunohistochemistry may help the challenging but prognostically relevant distinction between HCA and well‐differentiated HCC in male patients. NGS may be more important to subtype HCA than indicated in present guidelines. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14783223
Volume :
41
Issue :
10
Database :
Complementary Index
Journal :
Liver International
Publication Type :
Academic Journal
Accession number :
152558992
Full Text :
https://doi.org/10.1111/liv.14989