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Hepatocellular adenoma tumors shrink post-menopause

The size of hepatocellular adenoma tumors shrinks after menopause in women aged older than 50 years, according to recent findings published in Clinical Gastroenterology and Hepatology.

These results suggest that women with small hepatocellular adenoma tumors who experience menopause do not have to remain in follow-up.

“In this study we investigated if hepatocellular adenoma, a benign tumor of the liver that is found mostly in women and is associated with female hormones, regresses in size after the occurrence of menopause in female patients over 50 years of age,” Anne Julia Klompenhouwer, MD, a PhD student in the department of hepatology at Erasmus Medical Centre in the Netherlands, and colleagues wrote. “We made an ultrasound of the liver lesion and found that the average size of the adenomas becomes significantly smaller.”

Hepatocellular adenoma (HCA) is a rare liver tumor that develops in women during their reproductive phase and is associated with oral contraceptive use, the researchers wrote.

To evaluate whether HCA follow-up can be stopped safely after menopause and assess the impact of HCA diagnosis on health-related quality of life (HRQoL), they performed a cross-sectional cohort study of 48 post-menopausal women with HCA. Each patient underwent ultrasound and the size of each HCA tumor was compared with its size at last follow-up. Afterward, researchers evaluated HRQoL.

The median time since last follow-up was 60.5 months. In the final cohort of 44 patients, 43.5% of tumors were undetectable, 32.6% were stable and 19.6% became smaller. The average diameter was 17.2 mm compared with 35.9 mm at last follow-up (P < .001). There was a positive correlation between size difference and time since follow-up (P < .001). Further, the patients scored much lower in HRQoL compared with the general female Dutch population.

The researchers concluded that HCA diameter becomes significantly smaller after menopause and becomes even smaller as time passes, suggesting that routine follow-up of post-menopausal women with an HCA tumor diameter smaller than 5 cm is not required.

“Our results suggest that it is indeed safe to stop surveillance in post-menopausal patients with HCA less than 50 mm that showed regression in subsequent follow-up,” the researchers wrote. “We also saw a trend of regression in the lesions greater than 50 mm, however given the higher risk of complications in tumors greater than 50 mm it is advisable to consider keeping the patients with large HCA in follow-up.” – by Will Offit

Disclosure: The researchers report no relevant financial disclosures.