Transarterial embolization for hepatocellular adenomas: Case report and literature review

Hepatocellular adenoma (HCAs) is a rare benign tumor in the liver. Bleeding and malignant transformation are the two severe outcomes of HCAs. Transarterial embolization (TAE) is used to treat HCAs; however, its role in an elective setting is uncertain. Here, we report a case with HCA treated by TAE in an elective setting, followed by resection after 2 months, because of stable disease. Further, we performed a comprehensive review of PubMed database for studies published between January 2000 and June 2018 involving TAE to treat HCA. The review included 22 studies involving 1504 patients with HCA, of whom 89.4% were female. Only 171/1504 (11.4%) patients received TAE, among whom resection was avoided in 80 (46.8%) patients, of whom 31 (38.7%) were bleeding before TAE and 49 (61.3%) were not. Based on data of 115 tumors reviewed, the rate of complete and partial response were 9.6% and 74.8%, respectively, with an overall (complete + partial) response of 84.3%. No mortality or adverse side effects were noted. Therefore, both in elective setting and in the setting of bleeding, TAE can be considered safe in the management of HCAs and may be regarded as reasonable alternative management to hepatic resection.