Hepatocellular adenoma (HCA) HCA is a rare, substantial benign tumor of the liver, and most HCAs occur in association with oral contraceptive use. Some other factors causing HCA include androgen use, type I or III glycogen accumulation disorder, Klinefelter’s syndrome, complexinemia, familial adenomatous polyposis, diabetes mellitus, etc. When HCA is small, there are mostly no clinical symptoms, mostly in the liver transaminases are elevated, accidentally discovered during ultrasound or routine physical examination during pregnancy, the mass is often accompanied by abdominal distension when it is large and can be palpated in the upper abdomen When the mass is large, it is often accompanied by abdominal distension and palpable upper abdomen. When the mass bleeds or ruptures within the mass, abdominal pain is often present. Spontaneous hemorrhage from hepatic adenomas has been reported in the literature to be as high as 30%, especially during pregnancy when the mass grows rapidly due to elevated hormone levels, and rupture and bleeding of the mass often occurs. The patient’s laboratory tests are often unchanged, and when the tumor is large, there is often a mild increase in transaminases; AFP is often normal, and when elevated, it suggests hepatic adenoma malignancy. HCA is often solitary, sometimes with an envelope, and has clear borders with normal liver tissue, and histologically visible hepatocytes with cytoplasm rich in glycogen or fat, larger than normal hepatocytes, sometimes with mild nuclear heterogeneity, which makes differentiation from hepatocellular carcinoma difficult. The intensity of the echo depends on the ratio of glycogen to fat and the presence of hemorrhage and necrosis. Color Doppler often shows abundant blood flow in the periphery of the lesion. On ultrasonography, HCA is significantly enhanced in the arterial phase and isoechoic or slightly hypoechoic in the portal phase; on CT scan, an isointense mass is seen, and when there is hemorrhage, a high-density area is seen; on enhanced CT, a homogeneous high-density in the arterial phase and an isointense or hypointense signal in the portal or delayed phase. Due to the high resolution of fat and bleeding, MRI is one of the commonly used methods to examine HCA, with iso- or slightly high signal in T1-weighted and mildly high signal in T2-weighted. The sensitivity and specificity of using specifically enhanced MRI to identify HCA and FNH are 96.9% and 100%, respectively. It is worth emphasizing that routine puncture biopsy is not recommended for patients with suspected HCA because of the risk of hemorrhage on one hand and the difficulty of differentiating it from highly differentiated adenocarcinoma or FNH due to the small amount of tissue obtained by puncture on the other. The most common complications of HCA are bleeding and malignancy. Although HCA may shrink or even disappear after discontinuation of oral contraceptives, there are reports of lesions that do not change much after discontinuation and even progress to hepatocellular carcinoma years later. The rate of transformation to hepatocellular carcinoma is reported to be about 5% in the literature. Lesions smaller than 3 cm rarely have complications, so some scholars recommend regular follow-up, but it is important to avoid factors that promote the growth of HCA, such as discontinuing oral contraceptives and avoiding pregnancy. Patients with HCA larger than 4 cm or with an unclear diagnosis should be treated aggressively with measures such as surgical resection, radiofrequency ablation, and transhepatic artery embolization. In recent years. With the advancement of laparoscopic technology, some HCA can be done under laparoscopy; for multiple tumors, they can also be treated by a combination of surgical resection and radiofrequency ablation. In conclusion, asymptomatic hepatic hemangioma and FNH do not require special treatment. For those symptomatic cases, it should be determined whether the symptoms are caused by hemangioma or FNH, and the treatment plan should be carefully selected based on the size and location of the lesion, the patient’s general condition, and the operator’s proficiency. Hepatic adenomas, because of the risk of malignancy, should be treated aggressively with surgical resection or local ablation once diagnosed.