The malignant transformation of liver cell adenomas

Arch Surg. 1994 Jul;129(7):712-7. doi: 10.1001/archsurg.1994.01420310044007.


Objective: To investigate clinical experience with the apparent malignant transformation of benign liver cell adenomas.

Design: Retrospective review of personal experience and literature.

Setting: University hospital and affilated community hospitals.

Patients: All patients diagnosed with liver cell adenomas over a 30-year period.

Interventions: Liver resection and/or tumor biopsy.

Main outcome measures: Gender, age, drug associations, alpha-fetoprotein levels, response to treatment, and survival.

Results: Thirteen patients from personal experience and 26 patients from the reports of others had liver cell adenomas that were not resected. Five of these patients subsequently developed hepatocellular carcinoma.

Conclusions: Malignant transformation of a liver cell adenoma is a rare phenomenon, but it does occur. Alpha-fetoprotein levels may be more helpful in diagnosis than expected from previous reports. Solitary benign adenomas should be resected whenever possible. Patients with diffuse multiple tumors should be observed closely over a long period.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenoma / blood
  • Adenoma / chemically induced
  • Adenoma / epidemiology
  • Adenoma / pathology*
  • Adenoma / surgery
  • Adult
  • Biopsy
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / chemically induced
  • Carcinoma, Hepatocellular / epidemiology
  • Carcinoma, Hepatocellular / pathology*
  • Carcinoma, Hepatocellular / surgery
  • Cell Transformation, Neoplastic*
  • Combined Modality Therapy
  • Contraceptives, Oral / adverse effects
  • Estrogens, Conjugated (USP) / adverse effects
  • Female
  • Hepatectomy
  • Humans
  • Liver Neoplasms / blood
  • Liver Neoplasms / chemically induced
  • Liver Neoplasms / epidemiology
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Steroids / therapeutic use
  • Survival Rate
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • alpha-Fetoproteins / analysis


  • Contraceptives, Oral
  • Estrogens, Conjugated (USP)
  • Steroids
  • alpha-Fetoproteins