Diagnosis and Treatment of Hepatocellular Adenoma in the Netherlands: Similarities and Differences

Background: The diagnosis of hepatocellular adenoma (HA) has a great impact on the lives of young women and may pose clinical dilemmas to the clinician since there are no standardized protocols to follow. We aimed to establish expert opinions on diagnosis and treatment of HA by collecting data from a nationwide questionnaire in the Netherlands. Methods: A questionnaire was sent to 20 Dutch hospitals known to offer hepatologic and surgical experience on liver tumours. Results: 17 hospitals (85%) responded to the questionnaire. Annually, a median of 52 patients presented with a solid liver tumour. In 15 (88%) hospitals, hepatic adenomas were diagnosed with contrast-enhanced, multiphase spiral CT or MRI. In 2 (12%) hospitals, histology was required as part of a management protocol. Surveillance after withdrawal of oral contraceptives was the initial policy in all clinics. MRI, CT or ultrasound was used for follow-up. Criteria for surgical resection were a tumour size 1 5 cm and abdominal complaints. In 5 (29%) hospitals, patients were dismissed from follow-up after surgery. In complex cases (e.g. large, Published online: April 1, 2010 T. Terkivatan, MD, PhD Department of Surgery, Erasmus Medical Centre Rotterdam PO Box 2040, NL–3000 CA Rotterdam (The Netherlands) Tel. +31 107 040 704, Fax +31 104 635 058 E-Mail t.terkivatan @ erasmusmc.nl © 2010 S. Karger AG, Basel 0253–4886/10/0271–0061$26.00/0 Accessible online at: www.karger.com/dsu Parts of this article have previously been published in Dutch [Ned Tijdschr Geneeskd 2007;16:151].