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Surgery Liver ee8b1200

A 25-year-old woman complains of intermittent vague right upper quadrant (RUQ) pain. She has been on oral contraceptive tablets for 6 years. A CT scan of her abdomen shows multiple low-density solid masses occupying the entire right lobe of her liver as well as most of the left lobe. What is the best treatment for this patient?

A
Hepatic embolization
B
Discontinuation of oral contraceptives and a repeated CT scan of her abdomen in 3-6 months
C
CT-guided percutaneous needle biopsy of several liver masses
D
Laparoscopic biopsy of the liver masses and cholecystectomy
High-Yield Explanation
The CT scan findings of this patient plus the history of prolonged use of oral contraceptives are characteristic in hepatocellular adenoma. Because the tumor extensively involves both the right and left lobes of the liver, oral contraceptive use must be discontinued, and the patient must be observed for 3-6 months. Significant reduction in size of the adenoma has been noted in many cases after cessation of oral contraceptive use. If there is no regression of lesions, then liver transplantation should be recommended.

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