The malignant transformation of liver cell adenomas.

OBJECTIVE

To investigate clinical experience with the apparent malignant transformation of benign liver cell adenomas.

DESIGN

Retrospective review of personal experience and literature.

SETTING

University hospital and affilated community hospitals.

PATIENTS: All patients diagnosed with liver cell adenomas over a 30-year period.

INTERVENTIONS: Liver resection and/or tumor biopsy.

MAIN OUTCOME MEASURES: Gender, age, drug associations, alpha-fetoprotein levels, response to treatment, and survival.

RESULTS

Thirteen patients from personal experience and 26 patients from the reports of others had liver cell adenomas that were not resected. Five of these patients subsequently developed hepatocellular carcinoma.

CONCLUSIONS

Malignant transformation of a liver cell adenoma is a rare phenomenon, but it does occur. Alpha-fetoprotein levels may be more helpful in diagnosis than expected from previous reports. Solitary benign adenomas should be resected whenever possible. Patients with diffuse multiple tumors should be observed closely over a long period.