Derrick Arnold Doolittle MD, Presenter: Nothing to Disclose

Thomas Duncan Atwell MD, Abstract Co-Author: Nothing to Disclose

Taofic Mounajjed, Abstract Co-Author: Nothing to Disclose

David Maitland Hough MD, Abstract Co-Author: Nothing to Disclose

Grant D. Schmit MD, Abstract Co-Author: Nothing to Disclose

Anil Nicholas Kurup MD, Abstract Co-Author: Nothing to Disclose

Until recently, MRI with gadoxetate disodium (Eovist) was used to distinguish benign FNH from hepatic adenoma, the latter neoplasm having a small but real propensity for both spontaneous hemorrhage and malignant degeneration. Recently, an inflammatory variant of hepatic adenoma has been described which may demonstrate MRI imaging features similar to FNH, precluding diagnostic differentiation of these tumors. Given the implications of the different pathologies, there is a resurging interest in the role of biopsy in differentiating FNH and hepatic adenoma. The purpose of this project was to determine the safety and outcomes following biopsy of hepatic adenomas.

We performed a retrospective review of all patients at our institution over a 14 year interval with a confirmed biopsy proven diagnosis of hepatic adenoma. The biopsy procedure and complications of the biopsy were evaluated. Pathology-specific outcomes related to the diagnosis of adenoma were assessed.

Sixty-four patients were identified (56 females and 8 males, average age of 41.5 years) with an average follow up of 883 days after biopsy. Four (6%) patients had RF ablation the same day as the biopsy and complications were not assessed for these patients. Nine of the remaining 60 (15%) patients had a minor complication. There were no major complications. Three (5%) of our 64 biopsy-proven adenomas revealed focal nodular hyperplasia upon surgical resection. One biopsy proven adenoma was rebiopsied 3 months later, with result showing well differentiated hepatocellular carcinoma.

Complications of biopsy proven hepatic adenomas are rare. Although rare, discordant pathology results from biopsy and surgical resection may occur.

Biopsy of hepatic adenoma is safe with rare discordant results.

Doolittle, D, Atwell, T, Mounajjed, T, Hough, D, Schmit, G, Kurup, A, Safety and Outcomes Following Percutaneous Biopsy of Hepatic Adenomas.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013773.html