Benign hepatic tumors and their association with oral contraceptives

The growing number of reports of benign hepatic tumors occurring in young women who have been receiving oral contraceptive steroids has led us to review the 33 patients reported in the literature and to cite two additional case reports. By presenting two reports, one describing focal nodular hyperplasia and the other multiple hepatic cell adenomas, we hope to emphasize the pathological differentiation between these two lesions in order to calrify further reporting. Twelve of the 35 patients had massive intraperitoneal bleeding; two other patients had less severe hemoperitoneum. Five deaths have been reported. Although the frequency of use of these agents has become such that a direct relationship between them and benign hepatic tumors is not proved, the clinician should bear the association in mind when presented with women taking oral contraceptives who have abdominal pain. The review is made in the hope of stimulation further case reporting and microscopical and ultrastructural analysis. We trust that three will clarify the possible role of contraceptive steroids as predisposing or etiologic agents.