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Master Thesis

Tumeurs bénignes hépatocellulaires du foie‎ : prise en charge dans 2 centres chirurgicaux français‎ : étude rétrospective à propos de 144 patients opérés

Abstract : This study is retrospective and bi-centric (Grenoble, Lille) about 144 operated patients of a benign liver tumour, based on the pathologic diagnosis. Seventy-seven patients had at least 1 hepatic adenoma (AH group), 67 patients had at least 1 focal nodular hyperplasia (HNF group). Finally, radiologic examination has correctly classed 49 patients on 143 (34%). Frozen section examinations were done 15 times in laparoscopic group, 38 times in the laparotomy group. Fifty seven patients were operated by laparoscopy (1 major hepatectomy, 19 minor, 20 tumorectomies and 17 biopsies), and 87 by laparotomy (22 major hepatectomies, 42 minor, 16 tumorectomies, 7 biopsies). There were no mortality and morbidity was 43%. Mean follow-up was 15±19 months in the AH group and 18±20 months in the HNF group. Immunohistochemistry and molecular biology analysis had permitted to better classify 9 patients (7 HNF to AH group, and 2 telangiectatic HNF in HNF) and to know exactly the sub-type of AH. AH were classified in 5 sub-types (Zucman-Rossi classification): 20 type 1 (HNF1α mutated, LFABP-), 4 type 2 (β-catenine mutated), 38 type 3 (inflammatory AH, SAA+), 8 type 4 (No mutations) and 7 non classified. Hemorrhages have concerned 40% of AH. The only independent factor in multivariate analysis was lesion radiologic size (P=0.008). Nine hemorrhagic lesions measured less than 5 cm on histologic examination. With this study, we propose to discuss surgical resection of AH from 3 cm taking in account the simplicity of the procedure.
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Submitted on : Thursday, May 17, 2012 - 5:16:11 PM
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Romain Riboud. Tumeurs bénignes hépatocellulaires du foie‎ : prise en charge dans 2 centres chirurgicaux français‎ : étude rétrospective à propos de 144 patients opérés. Médecine humaine et pathologie. 2010. ⟨dumas-00623766⟩

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