Hepatic adenomas: phenotypic expression, case description and literature review

Background: Hepatic adenomas (HA) are rare and benign tumors, usually solitary and more common in women of reproductive age. HA can be classified into four categories according to the genotype-phenotypic aspects: mutation for HNF1α, associated with steatosis, mutation to β- catenin, with cellular atypias and relation with malignancy, inflammatory adenomas, characterized by infiltrates and sinusoidal dilation and, the last one, non-inflammatory adenomas without these previous findings. Methods: Our aims were described the casuistry of patients with HA in Clinic Hospital of State University of Sño Paulo Brazil from 1995 to 2015 and to review the literature on these tumors by classifying them according to the genotype-phenotypic presentation.A retrospective evaluation of clinical and epidemiological data of patients with a confirmed diagnosis of HA was made through an anatomopathological study, between 1995 and 2015. The evaluation of the histopathological characteristics of these tumors was made by two pathologists, they were classified into one of the four groups previously described. Results: Twenty cases of HA were identified in the period, 90% in females, most of them reporting oral contraceptive use (OAC). The most common clinical symptom was abdominal pain. The most comorbidities presented were arterial hypertension (n = 7) and diabetes mellitus (n = 3); 60% of the cases had only one nodule. There were 35% of ruptures and 02 cases of malignancy, with 14 patients submitted to surgical resection. Of the 14 patients operated, nine presented HA of subtype 4 - without morphological alterations. Conclusion: HA are rare nosological entities, but with the possibility of complications and malignization. The phenotypic study may help in the management of these patients with such diagnosis.