Hepatocellular carcinoma arising in hepatic adenoma: diagnostic and management implications

Hepatocellular adenomas (HCA) are benign neoplasms that rarely affect men. However, male subjects are more likely to develop a subset of β-catenin activated HCAs which are associated with a higher risk of malignant transformation. Moreover, glycogen storage disease is a known risk factor for the development of HCA. We report an unusual case of hepatocellular carcinoma arising in the background of multiple hepatic adenomas and glycogen storage disease type 2 in which a targeted liver biopsy failed to demonstrate the malignant component of the hepatocellular tumor. We discuss the main diagnostic criteria of HCA and its management implications.