Pathological condition lle11/21/2023 ![]() She tells you that she never comes to the emergency room, but decided to come in tonight because the pain in her right leg was keeping her awake. Your next patient is an obese, 35-year-old, female visitor from Australia with no known medical problems. It is another busy night in the emergency department five admitted patients are waiting for beds and three patients are waiting for CT scans. ![]() Once a working diagnosis is made, appropriate treatment can be initiated. The history and physical exam may reveal the cause to be related to previous trauma, surgery, systemic disease, infection, malignancy, or radiation therapy. As an emergency physician, it is crucial to consider all of the dangerous causes of a swollen extremity and to prioritize your diagnostic tests. The differential diagnosis is vast and includes a wide range of diseases from the benign to the potentially life threatening. Male sex, tumor size <50 mm, and lack of hepatobiliary CE-MRI were independent risk factors for postoperative change in tumor diagnosis.Patients presenting to the emergency department (ED) with a swollen extremity can be a diagnostic challenge. Resection for small (suspected) HCAs was mainly indicated by suspicion of (pre)malignancy, whereas for large (suspected) HCAs, tumor size was the most prevalent indication. Independent risk factors for change in diagnosis were tumor size <50 mm (adjusted odds ratio, 3.4 p < 0.01), male sex (aOR, 3.7 p = 0.03), and lack of hepatobiliary contrast-enhanced magnetic resonance imaging (CE-MRI) (aOR, 1.8 p = 0.04). Ninety-six (43%) patients had a postoperative change in diagnosis. No difference was observed in HCA-subtype distribution between small and large tumors. Independent risk factors for change in diagnosis were tumor size 50 mm (52%), suspicion of (pre)malignancy (28%), and (previous) bleeding (5.1%). We analyzed indications and outcome of patients operated for HCAs 50 mm (52%), suspicion of (pre)malignancy (28%), and (previous) bleeding (5.1%). Data on the indication for surgery are scarce. N2 - Hepatocellular adenomas (HCAs) are benign liver tumors associated with bleeding or malignant transformation. Hepatology Communications published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases. T2 - Indications and pathological discordance T1 - A nationwide assessment of hepatocellular adenoma resection Male sex, tumor size <50 mm, and lack of hepatobiliary CE-MRI were independent risk factors for postoperative change in tumor diagnosis.", Male sex, tumor size <50 mm, and lack of hepatobiliary CE-MRI were independent risk factors for postoperative change in tumor diagnosis.Ībstract = "Hepatocellular adenomas (HCAs) are benign liver tumors associated with bleeding or malignant transformation. Hepatocellular adenomas (HCAs) are benign liver tumors associated with bleeding or malignant transformation.
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