Benign tumors of the liver. I. Adenomas
Henson, S.W.; Gray, H.K.; Dockerty, M.B.
Surgery Gynecology and Obstetrics 103(1): 23-30
1956
ISSN/ISBN: 0039-6087 PMID: 13337626 Document Number: 8364
A review has been made of the records of 13 patients with benign adenomas of the liver seen at the Mayo Clinic from 1907 to 1954, inclusive. The tumors were classified histologically into 3 groups according to the predominant type of cell. Hepatoadenomas, the first group, are tumors composed of hepatic cells. Included are localized nodules of regenerative hyperplasia that have progressed to the formation of large tumors. They are distinguishable from hamartomas, with which they sometimes are confused, and probably require no treatment, although this has not been proved. Four large tumors of this type were included in the series. Cholangioadenomas, the second group, are tumors originating from bile ducts, usually in the form of small subcapsular collections of proliferating bile duct epithelium. They are commonly found at necropsy and are considered important because the surgeon must realize that they can simulate closely a metastatic deposit and, therefore, one should not assume that these small nodules are malignant until such is proved by biopsy. Seven such tumors were included. Cholangiohepatoadenomas, the third group, are mixed tumors originating from both hepatic cells and bile ducts. Two tumors of this type were included. Such lesions show pronounced hyperplasia of the connective tissue elements. These 2 tumors were similar to many that have been reported in the literature as hamartomas. They occur more frequently in infants than in adults and may grow to large size. They may be cystic or solid and usually are found in the right lobe. They should be excised if it is possible to do so. Four of these 13 patients underwent surgical exploration because of clinical manifestations thought to be caused by the hepatic tumor. These manifestations consisted of gradual enlargement of the abdomen, the discovery of an abdominal mass, or the presence of intermittent abdominal pain. Examination disclosed a palpable mass in each of these patients. Roentgenograms showed a mass displacing the diaphragm or the adjacent viscera in 3 of these 4 patients. The preoperative diagnosis was an indeterminate abdominal mass in each instance, with hepatic tumor being suggested in 2 instances.
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