Hepatic Adenoma
& Focal Nodular Hyperplasia
Treatment & Surgery

What is an hepatic adenoma or focal nodular hyperplasia?

Hepatic adenomas and Focal Nodular Hyperplasia (FNH) are benign tumours found in the liver. Hepatic adenomas and FNH are most common in women, with FNH accounting for approximately 8 percent of primary liver tumours, and hepatic adenoma is rare. Both can often be linked to use of the contraceptive pill.

These uncommon liver lesions can cause confusion and concern, but can usually be diagnosed with specialist scans and are often treated with surveillance only, rarely requiring surgery.


Hepatic Adenoma


Focal Nodular Hyperplasia (FNH)

Hepatic Adenoma & FNH Symptoms

Most hepatic adenomas or FNH will usually not present any signs or symptoms. Sometimes mild symptoms can include:

  • Jaundice (yellow discolouration of the skin and eyes)
  • Pain in that specific area of the abdomen
  • Nausea
  • A full feeling (typically occurring when a tumour has grown large enough to put pressure on other organs)

If the hepatic adenoma ruptures, this is very serious and can become life threatening (in rare cases). A ruptured hepatic adenoma can cause:

  • Sudden sharp abdominal pain
  • Internal bleeding
  • Low blood pressure

If you are experiencing any of these symptoms and are concerned, you should make an appointment with your doctor.

The most common risk factor associated with hepatic adenoma is the use of oestrogen-based oral contraceptive pills, with the risk increasing with prolonged use and higher doses. Some less common risk factors include:

  • Using steroids
  • Type 1 diabetes
  • Being overweight or obese
  • Using barbiturates
  • Excess iron in your blood

Hepatic Adenoma & FNH Diagnosis

FNH and hepatic adenomas display similar characteristics, and the risk of FNH being misdiagnosed with liver cancer is high, which is why it is essential for imaging tests to be interpreted by a specialist. You will likely be referred to a specialist who will perform the some or all of the following diagnostic tests:

  • Blood tests
  • Ultrasound
  • CT Scan
  • MRI
  • Diagnostic laparoscopy
  • Biopsy

Hepatic Adenoma & FNH Treatment

As these tumours are benign and generally rarely associated with complications, if they are small your doctor might suggest monitoring the tumour over time first before recommending treatment options.

If A/Prof Pilgrim can be certain the lesion really is an FNH (and not an hepatic adenoma), then these very rarely need any form of treatment or surveillance as they are not cancerous and do not become cancerous.

Hepatic adenoma however can become cancerous rarely, and can rupture so if they are large enough or have other concerning features, A/Prof Pilgrim would generally recommend surgical removal (depending on your age, fitness and characteristics of the hepatic adenoma such as its exact location within the liver for example).
Liver resection surgery may be recommended to remove the tumour if it is an hepatic adenoma (or if it can’t be certain that it is an FNH), especially if large as these tumours are more likely to lead to complications (such as rupturing and bleeding, or cancerous change).
If you have an hepatic adenoma or FNH and are concerned or would like to discuss treatment options please call our practice on (03) 9509 4811 to make an appointment, or you can book an appointment online