When should surgery be done for hepatic adenoma?

Surgery for hepatic adenoma is indicated primarily when there are concerning changes in the adenoma's characteristics, such as an increase in size or worsening symptoms. Hepatic adenomas are benign tumors of the liver often associated with the use of oral contraceptives (OCPs) or anabolic steroids.

When an adenoma increases in size, this raises concerns for the potential risk of complications, including hemorrhage or malignant transformation. Symptoms may also indicate that the adenoma is causing difficulties, such as abdominal pain or discomfort. Therefore, the decision to proceed with surgical intervention is based on these risk factors. Monitoring is typically recommended for smaller adenomas that are asymptomatic, especially if they are under 4 cm in diameter.

In contrast to the other options, a focus solely on size, asymptomatic status, or the resolution of symptoms after ceasing hormonal therapy does not take into account the dynamic nature of these tumors. Thus, surgery is warranted when there is evidence of growth or an exacerbation of symptoms, emphasizing the need for careful monitoring and timely intervention when changes are noted.