Hepatic Adenomas are rare, benign, but potentially premalignant hepatocellular neoplasms, accounting for <1% of all liver tumors, and occurring predominantly in young to middle-aged women. Growth is hormone-dependent and has a strong association with oral contraceptive and anabolic steroid use.  - Definition = Benign monoclonal proliferation of hepatocytes that lack normal portal tracts and bile ducts. Tumors have variable degrees of fat, inflammation, or dysplasia depending on subtype. These lesions are hormonally sensitive and carry a risk of hemorrhage and malignant transformation, especially in men, β-catenin–mutated subtypes, and lesions >5 cm.  - Imaging characteristics = Typically shows arterial phase hyperenhancement with variable washout on portal venous and delayed phases, often becoming hypoattenuating relative to liver. MRI signal is heterogeneous, reflecting fat, hemorrhage, or inflammation depending on subtype. On hepatobiliary phase imaging, lesions are hypointense due to absence of bile ducts and hepatocyte contrast uptake, a key feature distinguishing adenoma from FNH.  -Subtypes = Five subtypes have been identified:   - HNF1A-inactivated adenoma (35–45%) – fatty, low malignant risk.  - Inflammatory adenoma (40–50%) – T2 “atoll sign,” elevated CRP.  - β-catenin–mutated adenoma – highest malignant potential, resect.  - Sonic hedgehog adenoma – rare, may bleed.  - Unclassified adenoma (<10%) – lacks defining features.  Treatment & Surveillance =  - Discontinue OCPs or anabolic steroids, as many lesions regress after withdrawal.  - Repeat MRI 6 months after diagnosis or OCP discontinuation. If lesion is stable or regressing plan for annual imaging for 1-2 years to document stability.  - Surgical resection is recommended for:  - All men, regardless of size due to risk of misdiagnosed HCC or progression.  - Women with lesions >5 cm or β-catenin–mutated subtype.  - Bleeding adenomas: resuscitation, urgent transarterial embolization,  and close follow-up and plan for resection.   - If multiple adenomas, evaluate for glycogen storage disease or adenomatosis.  - If regression or resection after cessation of OCPs, MRI surveillance is advised to document stability.