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January 19, 1976

Liver Cell Adenoma-Reply

Author Affiliations

Chelsea Community Hospital Chelsea, Mich

JAMA. 1976;235(3):249. doi:10.1001/jama.1976.03260290011006

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In Reply.—  Dr Cornish's statement of the apparent resolution of the hepatic cell adenoma following the return to normal of the liver scan after surgical clipping of the right hepatic artery is disturbing. In our experience, positive liver scans have only been found in patients who have had hemorrhage into the tumor. Several asymptomatic patients whose lesions were discovered during physical examinations or during surgery have all had normal scans. In light of our experience, we would assume that the reason the scan on Dr Cornish's patient is now normal is because of subsidence of bleeding into the lesion.The patient should be examined angiographically, which, of course, will be difficult in view of the surgical clipping of the right hepatic artery. Possibly, portal venous studies via augmented superior mesenteric artery injections would demonstrate the lesion or at least the mass effect due to the lesion. Gray scale ultrasound might