TY - JOUR
T1 - Clinicopathologic characterization of hepatocellular adenomas in men
T2 - a multicenter experience
AU - González, Iván A.
AU - Torbenson, Michael
AU - Sharifai, Nima
AU - Byrnes, Kathleen
AU - Chatterjee, Deyali
AU - Kakar, Sanjay
AU - Yeh, Matthew M.
AU - Wu, Tsung Teh
AU - Zhang, Xuchen
AU - Jain, Dhanpat
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/8
Y1 - 2023/8
N2 - 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).
AB - 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).
KW - Androgen
KW - Atypical hepatocellular neoplasm
KW - Hepatocellular adenoma
KW - Hepatocellular carcinoma
KW - Hepatocellular neoplasm
KW - Men
UR - http://www.scopus.com/inward/record.url?scp=85162065446&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85162065446&partnerID=8YFLogxK
U2 - 10.1016/j.humpath.2023.05.010
DO - 10.1016/j.humpath.2023.05.010
M3 - Article
C2 - 37245629
AN - SCOPUS:85162065446
SN - 0046-8177
VL - 138
SP - 24
EP - 33
JO - Human Pathology
JF - Human Pathology
ER -