[A new case of hepatic adenomatosis. A critical review of the literature]

Abstract

Liver adenomatosis is a rare disease--only 22 cases are previously described--characterized by multiple adenomas (more than ten) in a normal parenchyma. After a literature review the authors cannot exclude a link between the estroprogestatives use and the development of adenomatosis. Most important risks are bleeding and development of new adenomas, after the operation. On the basis of an extensive literature review, diagnosis features, treatment and follow-up are discussed. The aim of this report is to describe a case of multiple adenomas in a 38 years old housewife treated for seven years with oral contraceptives, admitted to hospital for spontaneous subcapsular haemorrhage due to rupture of adenomas, macroscopically considered suggestive of angiomas during the operation. Right lobectomy was performed and microscopic examination diagnosed multiple adenomas (liver adenomatosis). A repeated CT scan eight months later showed more than three new nodules in the liver. A new right lobectomy and tumorectomy of the nodules in III liver segment (remained after the first operation for the erroneous diagnosis) was performed and over a period of 20 months the patient remains in excellent condition.