HCA is a benign tumor of the liver (Heise 2023). It can reach a diameter of more than 10 cm. Over the last two decades, there has been considerable progress in the research and diagnosis of HCA, which has led to the molecular and immunohistologic classification of HCA (Bioulac- Sage 2022).
HCA is currently divided into 6 different main subtypes, which are associated with specific risk factors and show different biological behavior (Klompenhouwer 2020):
1. H- HCA (HNF1A inactivated HCA [Klompenhouwer 2020]):
- Risk factors: MODY type 3, HNF1A germline mutations, microsatellite instability
- Clinical features: Hepatic adenomatosis
- Histological features: Intralesional steatosis (Hahn 2020)
- Frequency: 30 - 35 % (Renzulli 2019)
2nd I- HCA (inflammatory HCA [Klompenhouwer 2020]):
- Risk factors: obesity, alcohol, glycogenosis
- Clinical features: Inflammatory syndrome
- Histological features: Inflammatory infiltrate, sinusoidal enlargement
- Frequency: 30 - 50 % (Hahn 2020)
3. b ex3- HCA
- Risk factors: androgen therapy, male sex, hepatic vascular disease
- Clinical features: Frequently occurring malignant degeneration
- Histological features: Slight nuclear atypia, pseudoacinar formation (Hahn 2020)
- Frequency: 7 % (Renzulli 2019)
4. b- ex- 7.8 HCA
- Risk factors: No specific risk factors known
- Clinical features: No specific clinical features known
- Histological features: No specific features known (Hahn 2020)
- Frequency: 3 % (Renzulli 2019)
5. sh- HCA
- Risk factors: Obesity
- Clinical features: Symptomatic bleeding
- Histological features: Intratumoral hemorrhage (Hahn 2020)
- Frequency: 4 % (Renzulli 2019)
6th U- HCA (unclassified HCA [Klompenhouwer 2020])
- Risk factors: No specific risk factors known
- Clinical features: No specific clinical features known
- Histologic features: No specific features known
- Frequency: 7 % (Hahn 2020)