What is a hepatic adenoma and when should it be resected?

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Hepatic adenoma is a benign tumor of hepatocytes that is strongly tied to estrogen exposure (such as oral contraceptives or pregnancy). The main concerns with these lesions are the risk of spontaneous rupture and bleeding, which increases with lesion size and during pregnancy. Because of this, the management focuses on removing the tumor when the risk is high or symptoms are present. Resection is advised for larger lesions (commonly a threshold around 5 cm), when the tumor is causing symptoms, or if pregnancy is planned or ongoing, due to the heightened rupture risk during gestation. If the lesion is small and asymptomatic, stopping estrogen-containing therapy can lead to regression and observation may be appropriate.

The other descriptions mischaracterize hepatic adenoma: it is not a malignant tumor commonly linked to alcohol, it is not a cystic lesion requiring drainage, and it is not a vascular malformation treated only with embolization.