skip to main content

Hepatocellular Adenoma — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateGastroenterologyHepatocellular AdenomaRACP Adult Medicine

A 35-year-old woman on the OCP for 10 years has a 6 cm liver mass found on imaging. MRI shows a well-defined mass with intralesional fat, haemorrhage, and arterial enhancement WITHOUT a central scar. She has no chronic liver disease. AFP is normal. The lesion has a risk of malignant transformation. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Hepatocellular adenoma

Liver mass in a young woman on long-term OCP with intralesional fat and haemorrhage, WITHOUT central scar, and risk of malignant transformation is hepatocellular adenoma (HCA). OCP use is the strongest risk factor. HCA >5 cm has risk of haemorrhage and malignant transformation (especially β-catenin mutated subtype). Management: cease OCP (may cause regression), surgical resection if >5 cm or β-catenin positive. Subtype classification (inflammatory, β-catenin, HNF1α) guides management.

Reference: EASL – 2024 – Benign Liver Lesions; Bordeaux Classification