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[Hepatocellular adenoma after oral contraception]
L L Olesen1, M Vyberg, V Kruse
1Medicinsk-endokrinologisk afdeling, patologisk institut og radiologisk afdeling, Aalborg Sygehus.
Ugeskrift for Laeger
|October 5, 1992
Summary
Hepatocellular adenoma, a benign liver tumor, can regress after discontinuing oral contraceptives. Long-term oral contraceptive use increases adenoma risk, posing a hemorrhage risk.
Area of Science:
- Hepatology
- Oncology
- Endocrinology
Background:
- Oral contraceptive steroids are widely used, and their association with liver tumors requires careful consideration.
- Hepatocellular adenomas (HCA) are rare benign liver tumors, often linked to oral contraceptive use.
Observation:
- A 43-year-old woman presented with incidentally elevated serum alkaline phosphatase.
- Biopsy confirmed a hepatocellular adenoma, which regressed upon cessation of Neogentrol (oral contraception) after 17 years of use.
- The patient opted against invasive treatment, preferring observation.
Findings:
- Prolonged oral contraceptive steroid use (over two years) is associated with an increased incidence of hepatocellular adenomas.
- Hepatocellular adenomas are well-defined, solitary benign tumors with low malignant potential but a significant risk of rupture and hemorrhage.
- Histological examination is definitive for diagnosis, distinguishing HCA from hepatocellular carcinoma and focal nodular hyperplasia.
Implications:
- Hepatocellular adenomas require careful management, with options including surgical excision or embolization.
- For patients not undergoing immediate invasive treatment, regular monitoring via scanning is crucial to track tumor regression or progression.
- Advising against oral contraception and pregnancy is recommended due to the risk of tumor growth.