肝臟腺瘤：病例報告

Hepatic Adenoma: A Case Report

我們報告一肝臟腺瘤病例發生在一29歲女性，長期使用口服避孕藥，臨床上以無症狀但巨大肝腫瘤表現。過去並無B型肝炎或C型肝炎病史。腹部超音波，肝臟磁振照影，及動脈血管攝影均顯示一巨大肝腫瘤，疑肝臟腺瘤。病人接受開刀切除，術後病理檢查證實爲肝臟腺瘤。病人術後恢復良好，目前正在門診追蹤。回顧以往文獻，肝臟腺瘤以單發性爲主，多發性表現較少，好發於女性且多與避孕藥使用有關，另一方面，肝臟腺瘤很少發生在男性，且多與服用類固醇有關。肝臟腺瘤惡性轉變的機率很低，但仍有文獻報告；肝臟腺瘤有時須與分化良好的肝細胞癌作鑑別診斷。當巨大的肝臟腺瘤或合併破裂出血，臨床上無法與肝細胞癌作鑑別診斷時，或臨床懷疑有惡性轉變時，應考慮手術切除。對於多發性的肝臟腺瘤的治療方式可以考慮肝臟移植。

We reported a case of hepatic adenoma in a 29-year-old female patient who had history of chronic oral contraceptive use. She was told of a huge hepatic tumor during a health examination. There is no history of hepatitis B, or hepaptic C, neither abdominal discomfort was noted. Abdominal ultrasonography, liver M.R.I. and angiography disclosed a huge hepatic tumor, susp. hepatic adenoma in left lobe of liver. Laparotomy with extended left lobectomy was performed smoothly. Pathology further confirmed the diagnosis of hepatic adenoma. Hepatic adenoma is a benign tumor and most commonly occurs in women aged 15-45 who chronically use oral contraceptives. It usually presents with solitary lesion and multiple hepatic adenomas are much less common. Multiple hepatic adenomas are not always associated with oral contraceptive use. On the other hand, hepatic adenoma is rarely developed in men and usually related with the use of anabolicandrogenic steroids. Malignant transformation is rare, but even reported. Sometimes, it is difficult to differentiate from well-differentiated HCC. Surgery is necessary when there is a huge tumor associated with bleeding or to obtain a definite diagnosis.