A 36-year-old woman was referred for a specialist opinion regarding a newly discovered liver nodule.
The lesion was detected by ultrasonographic examination during assessment of acute right hypochondriac pain.
She was otherwise healthy, and was taking oral contraceptive pills.
The lesion was 2x3 cm in size and showed central hyper-echoic area suggestive of hemorrhage.
These features were further confirmed by MRI.
Her biochemistry was normal including serum alpha-fetoprotein.
The best therapeutic option is:
A- Monitoring with ultrasonography every 3 months
Triphasic CT scanning
C- Trans-arterial chemo-embolization
D- Radiofrequency ablation
E- Surgical resection
Check the answer and explanation below
Answer : E
The clinical scenario, combined with the radiological findings, is suggestive of hepatic adenoma (also called hepatocellular adenoma).
Oral contraceptives are associated with increased risk of hepatic adenomas.
Adenoma should be resected if it's symptomatic (hemorrhage or necrosis) , or it's
5 cm or more.
Asymptomatic and smaller adenomas are monitored on a regular basis.
Trans-arterial chemo-embolization and radiofrequency ablation are local therapies for hepatocellular carcinoma and not indicated for the treatment of hepatic adenoma.