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Hepatocellular adenoma as a risk factor for hepatocellular carcinoma in a non-cirrhotic liver: a plea against
  1. Caroline D M Witjes1,
  2. Fiebo J W ten Kate2,
  3. Susanna M van Aalten1,
  4. Roy S Dwarkasing3,
  5. François E J A Willemssen3,
  6. Cornelis Verhoef4,
  7. Robert A de Man5,
  8. Jan N M IJzermans1
  1. 1Department of Hepatobiliary and Transplantation Surgery, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
  2. 2Department of Pathology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
  3. 3Department of Radiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
  4. 4Department of Surgical Oncology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
  5. 5Department of Gastroenterology & Hepatology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
  1. Correspondence to Dr Caroline Witjes, Department of Surgery, Division Hepatobiliary and Transplantation Surgery, Erasmus University Medical Centre, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands; c.witjes{at}erasmusmc.nl

https://doi.org/10.1136/gutjnl-2012-302219

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    In their paper published in Gut, Farges et al report that in 23 out of 218 patients, areas of hepatocellular carcinoma (HCC) within hepatocellular adenoma (HCA) were observed, and the risk of malignant transformation was 4% in women and 47% in men.1 Hypothesising that HCC may arise from HCA is based on the assumption that at a certain point in time residual HCA or a transition zone with dysplastic changes (as found in colorectal cancers) is present within the malignant liver lesion.2

    The postulated theory presented by Farges et al may have great implications for the management of HCA. HCA, a rare benign liver tumour mostly occurring in young women, carries a small risk of malignant transformation …

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    Footnotes

    • Competing interests None.

    • Ethics approval Approved with permission of the ethical board.

    • Provenance and peer review Not commissioned; externally peer reviewed.