Liver adenoma, also called liver cell adenoma, is a benign (noncancerous) tumor in the liver. It is more common among women because of its link to estrogen-based birth control pills. While it is not common for liver adenomas to become cancerous, it is still important to take action to stop the growth of the tumor. Treatment steps may include stopping birth control pills or anabolic steroids and maintaining a healthy weight. Rarely is medical intervention or surgery needed to treat liver adenomas.
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What Are Liver Adenomas?
Liver or hepatocellular adenomas are benign tumors that form in the liver.
Rarely do liver adenomas become cancerous. When they do, doctors call this cancer hepatocellular carcinoma. The risk of these tumors becoming cancer is up to 10 times higher in men than in women.
How common are liver adenomas?
They are not common. Between 7 and 12 people out of 100,000 will get a liver adenoma at some point in their lives.
What causes liver adenomas?
Liver adenomas are often linked to hormonal changes in the body, specifically estrogen-based oral contraceptives for women and anabolic steroids for men.
Some people who get liver adenomas have changes in certain genes. Others have changes in specific proteins the body makes.
Doctors don't know for sure what causes liver adenomas to become cancerous. Researchers believe that having metabolic syndrome may be a factor.
Metabolic syndrome is the name for a group of risk factors that include:
- High blood sugar levels or having diabetes.
- High levels of triglycerides — a fat in your blood.
- Low levels of HDL, or good cholesterol.
- Obesity, chiefly with fat around your belly.
- Untreated high blood pressure.
You may also be at higher risk for adenoma liver cancer if you have cirrhosis or if your tumor is large.
Liver adenoma risk factors
Though liver adenomas are more common in men, women might be at greater risk if they:
- Are pregnant.
- Have glycogen storage disease (your body can't break down this type of sugar).
- Have metabolic syndrome.
- Take estrogen-based birth control pills.
- Use anabolic steroids (artificial testosterone).
Rarely, a benign liver adenoma may rupture. If rupture occurs, the tumor bleeds into the stomach, and doctors must do emergency surgery to stop this bleeding.
Complications of liver adenomas
The complications of liver adenomas include:
- Hemorrhaging (severe bleeding).
- Recurrence if not properly removed.
- Tumors becoming cancerous (hepatocellular carcinoma).
- Tumor rupture, especially if tumors are larger than 5cm.
What Are the Signs and Symptoms of Liver Adenomas?
Many people with these tumors don't have any symptoms at all, but some may have:
- A lump in the stomach.
- Pain in the upper right abdomen.
Severe stomach pain can occur if a liver adenoma bursts.
When should I see a doctor about my liver adenoma symptoms?
If you suspect you may have a liver adenoma, you should contact your primary care physician and set up an appointment.
How Do You Diagnose Liver Adenomas?
Doctors can diagnose liver adenomas with imaging tests such as:
- CT scans.
- MRI scans with contrast.
- Ultrasounds.
You may need a blood test to check your liver's function.
Doctors will check your blood for levels of certain enzymes your body makes. High levels of alpha-fetoprotein in your blood may show that a liver adenoma has become cancerous.
If doctors suspect your tumor has become cancerous, they may take a small sample of liver tissue, called a liver biopsy.
How Do You Treat Liver Adenomas?
Treatment for liver adenomas depends on the size of the tumor.
Doctors will make a treatment plan based on how big the tumor looks in imaging tests.
Lifestyle changes
Doctors might suggest you make certain lifestyle changes to help manage your tumor.
They may ask you to:
- Maintain a healthy weight with diet and exercise.
- Stop taking birth control pills (women).
- Stop using anabolic steroids (men).
Medical treatments
Depending on the size of the liver adenoma, medical treatments may include:
- Radiofrequency ablation — For tumors smaller than 3 centimeters. Using imaging, your doctor guides a needle electrode — or thin wire — into the tumor. Through the wire, they apply heat from high-frequency electrical currents to destroy the tumors.
- Transarterial embolization — For tumors larger than 5 centimeters. Doctors insert a thin tube, or catheter, into the femoral artery and target the tumors with an embolization agent. This drug blocks blood flow to the tumors and shrinks them.
Surgery
When liver adenomas are larger than 5 centimeters, surgeons use partial hepatectomy to remove them. During this liver surgery, they remove the tumor and some tissue near it. They leave the healthy part of your liver.
Since men are at greater risk of liver adenoma becoming cancerous, surgeons often remove the tumors no matter their size.
If liver cancer is in an advanced stage, doctors may talk with you about a liver transplant.
In liver transplants, surgeons take out the whole diseased liver and replace it with a healthy liver from a deceased donor or a lobe of liver from a living donor.
Why Choose UPMC for Liver Adenoma Care?
At the UPMC, our experts diagnose and treat all liver conditions, including benign and cancerous liver adenomas.
We work closely with liver cancer and liver transplant experts to tailor each person's treatment.
