Hepatocellular adenomas associated with antiepileptic drugs: A case report

Abstract

Hepatocellular adenoma (HCA) represents a rare benign liver tumor occurring predominantly in females of reproductive age and taking oral contraceptives. They are associated with various conditions. We report the case of a male patient with hepatic adenomas who has an association with long-term antiepileptic drugs in treatment for seizures of Rasmussen's encephalitis without a history of anabolic steroid use or any underlying hyperestrogenism. MRI findings show multiple hepatic nodules with mainly intermediate signal on T2, intratumoral fat content without diffusion restriction, and intense enhancement in the arterial phase with and without washout in portal and equilibrium phases. The imaging characteristics of these adenomas are indicative of the HNF1 alpha-inactivated subtype. No therapeutic interventions have been performed so far. This association is rare, and few cases have been reported in the literature. This case aims to reaffirm and remind people of the association of hepatic adenomas with antiepileptic drug use and make an additional analysis of the new molecular subtypes of hepatic adenoma, described recently in the literature. Exhaustive literature research reveals few case reports.