The liver is a large organ that sits in the upper right part of the abdomen, under the ribcage. The liver has many important functions including:

• breaking down and removing waste
• helping the blood to clot
• storing sugar
• making bile

Liver adenomas are benign (not cancer) growths that develop from the liver cells. They may be single or there may be multiple adenomas scattered within the liver.

It is not clear why liver adenomas develop but risk factors include obesity and fatty liver and use of the oral contraceptive pill or anabolic steroids. Liver adenomas are more common in women but do sometimes occur in men.

In most cases, in women, liver adenomas are not harmful and do not cause symptoms. Occasionally when they are large, they may rupture and bleed or may turn into liver cell cancer. Liver adenomas in men have a greater risk of becoming malignant.

Liver cell adenomas are usually picked up on a scan such as an ultrasound or CT of the abdomen that have been done for other reasons. An MRI with injection of a contrast into the bloodstream (Primovist) is the best test to diagnose a liver adenoma. Making the diagnose can sometimes be difficult and occasionally a biopsy is required.

In most cases in women, liver adenomas can be safely observed with periodic scans under the care of a liver specialist. It is important to stop any oestrogen containing hormone therapy (such as the oral contraceptive pill) as these may stimulate the adenoma to grow. If you are overweight, you should lose weight. Some adenomas shrink or even disappear after stopping the pill and losing excess weight.

It is also important to tell your doctor if you are pregnant or planning on getting pregnant as hormones in pregnancy can also stimulate growth of the adenoma. Closer monitoring during pregnancy is required.

When there is a concern about risk of bleeding or potential for the adenoma to turn into a cancer, surgery to remove the part of the liver containing the adenoma is recommended.

In men, there is a higher chance of adenomas becoming a cancer and surgery is advised.