Hepatocellular adenoma with activation of the β-catenin mutation pathway mimicking intrahepatic cholangiocarcinoma: Case report

Hepatocellular adenomas are relatively rare benign tumors of the liver that primarily develop in young women, particularly those who use oral contraceptive pills. There are 4 distinct subtypes of these tumors. Among them, β-catenin-mutated adenomas constitute approximately 10% to 15% and are notable for their potential to undergo malignant transformation. In this report, we present the case of a young patient who had a 4 cm hepatic lesion. The initial imaging studies, particularly an MRI, suggested that the lesion might be an intrahepatic cholangiocarcinoma. However, upon further histological examination, the lesion was identified as a benign hepatic adenoma, with activation of the β-catenin mutation pathway. Due to the associated risk of malignant transformation, the treatment plan included surgical resection of the adenoma. This approach is critical in managing such lesions to prevent any potential progression to hepatocellular carcinoma.