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Clinicopathologic characterization of hepatocellular adenomas in men: a multicenter experience

2023; Elsevier BV; Volume: 138; Linguagem: Inglês

10.1016/j.humpath.2023.05.010

1532-8392

Iván González, Michael Torbenson, Nima Sharifai, Kathleen Byrnes, Deyali Chatterjee, Sanjay Kakar, Matthew M. Yeh, Tsung‐Teh Wu, Xuchen Zhang, Dhanpat Jain,

Genomics, phytochemicals, and oxidative stress

Hepatocellular adenomas (HCAs) are benign liver neoplasms which most commonly present in women in their reproductive age. In men, they are rare and have a higher risk of malignant transformation to hepatocellular carcinoma (HCC). Here we present our multicenter experience with HCA in men in the United States. A total of 27 HCA cases were included, with a mean age of presentation of 37 years (range, 9–69 years) and a mean size of 6.8 cm (range, 0.9–18.5 cm). Based on the 2019 World Health Organization classification, the most common subtype identified was inflammatory HCA (IHCA; 10 cases, 37.0%) followed by unclassified HCA (UHCA; 7 cases, 25.9%), HNF1A-inactivated HCA (H-HCA; 6 cases, 22.2%), β-catenin–activated IHCA (b-IHCA; 3 cases, 11.1%), and β-catenin–activated HCA (b-HCA; 1 case, 3.7%). Six additional cases diagnosed as hepatocellular neoplasm of uncertain malignant potential (HUMP) were also included in the study. These cases presented in a mean age of 46 years (range, 17–64 years) and a size of 10.8 cm (range, 4.2–16.5 cm). We evaluated the significance of androgen receptor (AR) expression by immunohistochemistry (IHC); of the 16 cases with materials available, 8 were considered positive using the Allred score system (2 IHCA, 2 H-HCA, 1 UHCA, and 3 HUMP). Of the total cases, 12 were diagnosed on biopsies, for which follow-up information is available for 7, and none of them show evidence of malignant transformation. Of the 21 resection cases, a concomitant well-differentiated HCC within the same lesion was identified in 5 cases (23.8%), which were diagnosed as HCA (n = 4) or HUMP (n = 1). Overall, 15% of cases in our entire cohort of HCA and HUMP showed concomitant HCC, while none of the 7 biopsy cases showed any malignant transformation on follow-up (range, 22–160 months; mean, 61.8 months).