To investigate the diagnostic characteristics of β-catenin mutated activated hepatocellular adenoma (β-HCA).

The clinical and imageology data of a case of β-HCA pathologically confirmed by puncture biopsy on February 6, 2020 in the Ultrasound Department of Jining NO.1 People′s Hospital were retrospectively analyzed, and the literatures were reviewed.

The 31-year-old female patient, without any clinical symptoms, was admitted to hospital after physical examination with focal liver lesions. The ultrasonic manifestations of β-HCA were slightly circular higher echo with rich blood supply and uneven internal echo. Contrast-enhanced ultrasound showed rapid enhancement in arterial phase and low enhancement in portal and delayed phases. Histopathological examination revealed hepatocellular adenoma with purpuric hemorrhage. Immunohistochemistry: cytokeratin 8 (CK8) (+ + + ), cluster of differentiation antigen 34 (CD34) (capillary + ), CD10(focal + ), heat shock protein 70 (HSP70) (focal + ), glutamine synthase (GS) (+ + + ), β-catenin (membrane + ), and β-HCA was confirmed.

β-HCA has no specific clinical manifestations. Contrast-enhanced ultrasound can show rapid enhancement in arterial phase, rapid clearance or equal enhancement in portal vein phase, low enhancement or equal enhancement in delayed phase, the final diagnosis depends on histopathological and immunohistochemical analysis.