The majority of HAs are clinically occult and are incidentally detected on imaging. The risk factors for hemorrhage are size >5 cm, a subcapsular location and longstanding OCP use.[10,18,19] HCA associated with hemorrhage may present with acute abdominal pain, elevated liver enzymes, and hypovolemic shock. Inflammatory HCA has the highest risk of hemorrhage and may show elevated levels of acute-phase reactants. The β-catenin activated subtype has the highest predilection for malignant transformation of all HCAs and this may be seen as a rapid increase in the size of a previously known HCA.[10,18,19]
Appl Radiol. 2019;48(6):21-29. © 2019 Anderson Publishing, Ltd.