In recent years the diagnostic and therapeutic approach to hepatocellular adenoma has undergone considerable innovations. New imaging techniques have revolutionized diagnosis and have also made it possible to investigate the subtype of the lesion. The development of molecular studies has demonstrated the existence of several subtypes of the tumor, with different behavior, which implies a different therapeutic concept. These facts have significantly influenced surgical approaches. Classically the surgical indication was universal, however there has been a change in the therapeutic attitude, with a more conservative tendency, limiting the indications for liver resection and liver transplantation. The new molecular classification of adenomas, together with immunohistochemical techniques, allow us to establish different scenarios that will help us to establish specific therapeutic criteria. Likewise, the development of minimally invasive surgical techniques, such as laparoscopy and robotics, which are increasingly used, pose a change of scenario since they involve less aggression for the surgical patient.
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