What is the role of serologic testing in the workup of hepatocellular adenoma (HCA)?

Updated: Feb 21, 2018
  • Author: Bradford A Whitmer, DO; Chief Editor: BS Anand, MD  more...
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Serologically, hepatocellular adenomas are a diagnosis of exclusion. No specific serologic studies exist.

Serum aminotransferase (aspartate aminotransferase [AST]/alanine aminotransferase [ALT]) levels are mildly elevated in approximately 50% of patients, likely due to the mass effect of the tumor.

Serum alpha-fetoprotein (AFP) levels are within the reference range in patients with hepatocellular adenoma. Elevations are noted in 50% of hepatocellular carcinoma (HCC) cases. Thus, finding an elevated AFP represents either a primary carcinoma or an adenoma that has undergone malignant transformation. An AFP level within the reference range does not eliminate HCC from the differential diagnosis.

Elevated carcinoembryonic antigen (CEA) levels suggest metastasis from the colon.

Serologies for amebiasis and echinococcus should be considered if the lesion appears cystic.

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