Drug Discov Ther. 2026;20(5):405-408. (DOI: 10.5582/ddt.2026.01086)

Surgical indications for hepatocellular adenoma: Diagnostic uncertainty and molecular risk stratification

Tan JY, Shen A

Surgical management of hepatocellular adenoma (HCA) is still guided principally by patient sex, tumor size, and growth, although molecular classification has revealed important biological differences. Retrospective studies have also exposed diagnostic discordance, complicating the interpretation of historical estimates of malignant risk. Molecular subtypes differ in their associations with hemorrhage and malignant transformation, but evidence that subtype-guided management improves outcomes remains limited. Proposals to observe selected men with small lesions have reopened the debate over routine resection. We examine how diagnostic confidence, molecular heterogeneity, and the limitations of available outcome data should inform surgical decisions. Any change in practice should be supported by validated estimates of clinical risk rather than molecular findings alone.

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